1981—2016年辽宁省肾综合征出血热特征分析
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摘要
目的探索辽宁省肾综合征出血热(HFRS)发病规律及流行趋势,为制定预防措施提供科学依据。方法采用回顾性方法,收集1981—2016年辽宁省HFRS疫情数据和人口资料,分析HFRS时间、地区、人群发病的变化情况。结果 1981—2016年,辽宁省HFRS发病率波动在0.86/10万～13.04/10万之间,年平均发病率为4.16/10万,年平均死亡率为0.06/10万,平均病死率为1.52%。36年间出现了3个明显的发病周期(1981—1990年,1991—2009年,2010—2016年),第3个发病周期发病率波动较小,在1.67/10万～3.00/10万之间。HFRS秋冬峰(10-12月)和春夏峰(3-6月)发病例数的比值在1981—1998年维持在一个较高水平,最高比值达14,1999—2016年秋冬峰与春夏峰发病例数的比值小于1。80年代初,疫区主要分布在辽宁省东部和中部,之后逐渐向西部和南部扩散。进入21世纪后,疫区扩大至全省2/3以上的县区,现主要集中在西部地区的葫芦岛、锦州以及东部地区的铁岭、抚顺地区。在人群分布上男性多于女性,以农民为主,15-64岁年龄组发病率最高。结论 1981-2016年,辽宁省HFRS发病率经过2个较大发病周期后,逐渐降低至3/10万,流行季节性在90年代后期发生转变,秋冬峰与春夏峰发病人数比例发生逆转,疫区逐渐扩大,推断疫区类型由姬鼠型混合疫区向家鼠型混合疫区演变。
To explor the incidence and prevalence of Hemorrhagic fever with renal syndrome(HFRS) in Liaoning province, and provide scientific evidence for the development of preventive measures,a retrospective method was used to collect HFRS epidemic data and population data from 1981 to 2016 in Liaoning province. This method was used to analyze the changes in time, region, and population morbidity.From 1981 to 2016, the incidence of HFRS in Liaoning province fluctuated between 0.86/100 000 and 13.04/100 000. The annual average incidence rate was 4.16/100 000, the annual average mortality rate was 0.06/100 000, and the average case fatality rate was 1.52%.Three distinct morbidity cycles occurred in past 36 years(1981-1990, 1991-2009, 2010-2016), and the incidence of the third morbidity fluctuated less, ranging from 1.67/100 000 to 3.00/100 000. The ratio of the number of cases of HFRS autumn and winter peaks(October-December) and spring-summer peaks(March-June) was maintained at a high level from 1981 to 1998, with the highest ratio reaching 14. The ratio of the number of cases of autumn and winter peaks to spring and summer peaks in 1999-2016 was less than 1. In the early 1980 s, the epidemic areas were mainly distributed in the eastern and central parts of Liaoning province, and then gradually spread to the west and south. After entering the 21 st century, the epidemic area has expanded to more than two-thirds of the county. It is mainly concentrated in Huludao and Jinzhou in the western region and Tieling and Fushun in the eastern region. The distribution of the population is characterized with men more than women, mainly farmers, and the highest incidence rate in the 15-64 age group. From 1981 to 2016, the incidence of HFRS in Liaoning province gradually decreased after the two major onset cycles, the disease became stable. The seasonality of the epidemic changed in the late 1990 s. The proportion of the incidence of autumn and winter peaks and spring and summer peaks has reversed, and the epidemic areas have also changed. The type of epidemic area may evolve from the Apodemus mixed epidemic area to the epidemic-type mixed-type epidemic area.
To explor the incidence and prevalence of Hemorrhagic fever with renal syndrome(HFRS) in Liaoning province, and provide scientific evidence for the development of preventive measures,a retrospective method was used to collect HFRS epidemic data and population data from 1981 to 2016 in Liaoning province. This method was used to analyze the changes in time, region, and population morbidity.From 1981 to 2016, the incidence of HFRS in Liaoning province fluctuated between 0.86/100 000 and 13.04/100 000. The annual average incidence rate was 4.16/100 000, the annual average mortality rate was 0.06/100 000, and the average case fatality rate was 1.52%.Three distinct morbidity cycles occurred in past 36 years(1981-1990, 1991-2009, 2010-2016), and the incidence of the third morbidity fluctuated less, ranging from 1.67/100 000 to 3.00/100 000. The ratio of the number of cases of HFRS autumn and winter peaks(October-December) and spring-summer peaks(March-June) was maintained at a high level from 1981 to 1998, with the highest ratio reaching 14. The ratio of the number of cases of autumn and winter peaks to spring and summer peaks in 1999-2016 was less than 1. In the early 1980 s, the epidemic areas were mainly distributed in the eastern and central parts of Liaoning province, and then gradually spread to the west and south. After entering the 21 st century, the epidemic area has expanded to more than two-thirds of the county. It is mainly concentrated in Huludao and Jinzhou in the western region and Tieling and Fushun in the eastern region. The distribution of the population is characterized with men more than women, mainly farmers, and the highest incidence rate in the 15-64 age group. From 1981 to 2016, the incidence of HFRS in Liaoning province gradually decreased after the two major onset cycles, the disease became stable. The seasonality of the epidemic changed in the late 1990 s. The proportion of the incidence of autumn and winter peaks and spring and summer peaks has reversed, and the epidemic areas have also changed. The type of epidemic area may evolve from the Apodemus mixed epidemic area to the epidemic-type mixed-type epidemic area.
引文
[1] 李德新.加强肾综合征出血热的预防控制[J].中华实验和临床病毒学杂志, 2008, 22(1):1-1. DOI:10.3760/cma.j.issn.1003-9279.2008.01.001
[2] 中华人民共和国国家卫生和计划生育委员会.全国肾综合征出血热监测方案(试行)[S].北京:中国人民共和国卫生部,2005.
[3] 张永振,肖东楼,王玉,等.中国肾综合征出血热流行趋势及其防制对策[J].中华流行病学杂志, 2004, 25(6):466-469. DOI:10.3760/j.issn:0254-6450.2004.06.002
[4] 刘敏,姚文清,孙英伟,等.辽宁省2001-2006年肾综合征出血热疫情分析与控制策略[J].中华流行病学杂志, 2007, 28(8):832-832. DOI:10.3760/j.issn:0254-6450.2007.08.036
[5] 宋干.新中国流行性出血热防治研究的主要成就[J].中华流行病学杂志, 2000, 21(5):378-382. DOI:10.3760/j.issn:0254-6450.2000.05.019
[6] 黄晓霞,李德新.病毒性出血热概述[J].中国国境卫生检疫杂志,2018,41(2):139-143. DOI:10.3969/j.issn.1008-5777.2004.04.018
[7] 赵铁镪.辽宁省肾综合征出血热流行病学研究综述[J].中国媒介生物学及控制杂志, 1997, 8(5):397-399.
[8] 秦彩明,刘芸,姚文清,等.辽宁省鼠类感染肾综合征出血热的病原学及分子生物学检测比较[J].中国人兽共患病学报, 2010, 26(6):528-531.
[9] 秦彩明,姚文清,吴绍慧,等.辽宁省肾综合征出血热基因分型及序列分析[J].中国卫生检验杂志, 2007, 17(4):626-628. DOI:10.3969/j.issn.1004-8685.2007.04.021
[10] 张洁,王子江,李鑫,等.辽宁省2012-2013年发热伴出血症候群监测结果分析[J].中国公共卫生, 2014, 30(6):822-824. DOI:10.11847/zgggws2014-30-06-45
[11] 韩悦,石有昌,刘敏,等.辽宁省1991-2000年流行性出血热疫情分析[J].疾病监测, 2001, 16(10):382-384. DOI:10.3784/j.issn.1003-9961.2001.10.018
[12] 刘静,王洁贞,薛付忠,等.肾综合征出血热发病率与气象因素关系的研究[J].中国卫生统计, 2006, 23(4):326-329. DOI:10.3969/j.issn.1002-3674.2006.04.011
[13] 刘晓冬.中国肾综合征出血热时空分布及气候因素对辽宁省HFRS影响的研究[D].济南:山东大学,2012
[14] 孙英伟,韩阳欢,李鑫,等.辽宁省2007-2011年肾综合征出血热疫情监测分析[J].中国公共卫生, 2012, 28(6):838-840. DOI: 10.11847/zgggws-2012-28-06-46
[15] 吴静.长春市肾综合征出血热地理流行病学及病原基因序列分析[D].长春:吉林大学,2015.
[16] 姚文清,郭军巧,孙英伟,等.辽宁省肾综合征出血热干预措施效果评价[J].中国公共卫生, 2008, 24(11):1361-1362. DOI:10.3321/j.issn:1001-0580.2008.11.053
[2] 中华人民共和国国家卫生和计划生育委员会.全国肾综合征出血热监测方案(试行)[S].北京:中国人民共和国卫生部,2005.
[3] 张永振,肖东楼,王玉,等.中国肾综合征出血热流行趋势及其防制对策[J].中华流行病学杂志, 2004, 25(6):466-469. DOI:10.3760/j.issn:0254-6450.2004.06.002
[4] 刘敏,姚文清,孙英伟,等.辽宁省2001-2006年肾综合征出血热疫情分析与控制策略[J].中华流行病学杂志, 2007, 28(8):832-832. DOI:10.3760/j.issn:0254-6450.2007.08.036
[5] 宋干.新中国流行性出血热防治研究的主要成就[J].中华流行病学杂志, 2000, 21(5):378-382. DOI:10.3760/j.issn:0254-6450.2000.05.019
[6] 黄晓霞,李德新.病毒性出血热概述[J].中国国境卫生检疫杂志,2018,41(2):139-143. DOI:10.3969/j.issn.1008-5777.2004.04.018
[7] 赵铁镪.辽宁省肾综合征出血热流行病学研究综述[J].中国媒介生物学及控制杂志, 1997, 8(5):397-399.
[8] 秦彩明,刘芸,姚文清,等.辽宁省鼠类感染肾综合征出血热的病原学及分子生物学检测比较[J].中国人兽共患病学报, 2010, 26(6):528-531.
[9] 秦彩明,姚文清,吴绍慧,等.辽宁省肾综合征出血热基因分型及序列分析[J].中国卫生检验杂志, 2007, 17(4):626-628. DOI:10.3969/j.issn.1004-8685.2007.04.021
[10] 张洁,王子江,李鑫,等.辽宁省2012-2013年发热伴出血症候群监测结果分析[J].中国公共卫生, 2014, 30(6):822-824. DOI:10.11847/zgggws2014-30-06-45
[11] 韩悦,石有昌,刘敏,等.辽宁省1991-2000年流行性出血热疫情分析[J].疾病监测, 2001, 16(10):382-384. DOI:10.3784/j.issn.1003-9961.2001.10.018
[12] 刘静,王洁贞,薛付忠,等.肾综合征出血热发病率与气象因素关系的研究[J].中国卫生统计, 2006, 23(4):326-329. DOI:10.3969/j.issn.1002-3674.2006.04.011
[13] 刘晓冬.中国肾综合征出血热时空分布及气候因素对辽宁省HFRS影响的研究[D].济南:山东大学,2012
[14] 孙英伟,韩阳欢,李鑫,等.辽宁省2007-2011年肾综合征出血热疫情监测分析[J].中国公共卫生, 2012, 28(6):838-840. DOI: 10.11847/zgggws-2012-28-06-46
[15] 吴静.长春市肾综合征出血热地理流行病学及病原基因序列分析[D].长春:吉林大学,2015.
[16] 姚文清,郭军巧,孙英伟,等.辽宁省肾综合征出血热干预措施效果评价[J].中国公共卫生, 2008, 24(11):1361-1362. DOI:10.3321/j.issn:1001-0580.2008.11.053