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2016-2020年黑龙江省齐齐哈尔市肾综合征出血热流行特征分析

Epidemiological characteristics of hemorrhagic fever with renal syndrome in Qiqihar City, Heilongjiang Province from 2016 to 2020

摘要目的:分析齐齐哈尔市肾综合征出血热(HFRS)流行特征,了解HFRS流行及发展规律,为制定有针对性的防控措施提供科学依据。方法:采用回顾性分析方法,自中国疾病预防控制信息系统收集2016-2020年齐齐哈尔市HFRS病例数据,利用描述流行病学方法分析HFRS的三间分布(时间、地区、人群分布)情况。同时,自讷河市疾病预防控制中心收集2016-2020年讷河市鼠监测数据,进行描述分析。结果:2016-2020年,齐齐哈尔市累计报告HFRS病例868例,死亡10例,年均发病率为3.26/10万,年均死亡率为0.04/10万,病死率为1.15%;2016-2020年发病率分别为3.23/10万、3.31/10万、3.22/10万、4.10/10万、2.43/10万;全年各月均有发病,10-12月为发病高峰期(累计490例);HFRS年均发病率居前5位的县(市)分别是讷河市(7.46/10万)、克山县(5.03/10万)、甘南县(3.84/10万)、富裕县(3.82/10万)、泰来县(3.63/10万);发病人群中男性占76.04%(660/868),女性占23.96%(208/868);发病年龄主要集中在30~69岁,占总病例数的81.57%(708/868);职业分布以农民为主,占总病例数的75.46%(655/868)。2016-2020年讷河市鼠监测结果显示,野外和村内鼠种均以褐家鼠为主,占比分别为65.13%(581/892)和80.21%(466/581);春季野外和村内鼠密度分别为3.37%(397/11 771)和6.64%(275/4 141),秋季野外和村内鼠密度分别为8.47%(495/5 843)和9.40%(306/3 254)。各鼠种的带毒率,褐家鼠较高,为13.14%(131/997);感染率褐家鼠也较高,为15.15%(151/997);村内各鼠种的带毒率和感染率均高于野外各鼠种(χ 2 = 6.87, P = 0.009;χ 2 = 13.05, P < 0.001)。 结论:齐齐哈尔市HFRS发病率2016-2018年处于较平稳状态,2019年发病率上升,2020年回落;发病时间主要集中在秋冬季,以男性为主,职业主要为农民。2016-2020年齐齐哈尔市各县(市、区)中,讷河市HFRS发病率较高,秋季的鼠密度高于春季,鼠种构成主要是褐家鼠,其带毒率、感染率均较高。

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abstractsObjective:To analyze the epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS) in Qiqihar City, and to understand the epidemic and development rules of HFRS, and to provide scientific basis for formulating targeted prevention and control measures.Methods:The data of HFRS cases in Qiqihar City from 2016 to 2020 were collected from the China Disease Control and Prevention Information System by retrospective analysis, and the three distributions (time, region and population distribution) of HFRS were analyzed by descriptive epidemiology. At the same time, the monitoring data of rats in Nehe City from 2016 to 2020 were collected from the Nehe Municipal Center for Disease Control and Prevention for descriptive analysis.Results:From 2016 to 2020, 868 HFRS cases were reported in Qiqihar City, with 10 deaths. The average annual incidence rate was 3.26/100 000, the average annual mortality rate was 0.04/100 000, and the case fatality rate was 1.15%. From 2016 to2020, the incidence rates were 3.23/100 000, 3.31/100 000, 3.22/100 000, 4.10/100 000 and 2.43/100 000, respectively. Incidence occurred in all months of the year, with the peak period from October to December (490 cases in total). The top five counties(cities) with the incidence of HFRS were Nehe City (7.46/100 000), Keshan County (5.03/100 000), Gannan County (3.84/100 000), Fuyu County (3.82/100 000) and Tailai County (3.63/100 000). Among the patients, 76.04% (660/868) were male and 23.96% (208/868) were female; the age of onset was mainly 30-69 years old, accounting for 81.57% (708/868) of the total cases; the occupation distribution was mainly farmers, accounting for 75.46% (655/868) of the total cases. The results of rat monitoring in Nehe City from 2016 to 2020 showed that Rattus norvegicus was the dominant species in the field and village, accounting for 65.13% (581/892) and 80.21% (466/581), respectively. In spring, the rat density in the field and village was 3.37% (397/11 771) and 6.64% (275/4 141), respectively; in autumn, the rat density in the field and village was 8.47% (495/5 843) and 9.40% (306/3 254), respectively. The virus carrying rate of Rattus norvegicus was high, 13.14% (131/997); the infection rate of Rattus norvegicus was also high, 15.15% (151/997); the virus carrying rate and infection rate in the village were higher than those in the field (χ 2 = 6.87, P = 0.009; χ 2 = 13.05, P < 0.001). Conclusions:The incidence of HFRS in Qiqihar City is relatively stable from 2016 to 2018, rising in 2019 and falling back in 2020; the onset time is mainly in autumn and winter, mainly male and farmers. From 2016 to 2020, among all counties (cities, districts) in Qiqihar City, the incidence of HFRS in Nehe City is high, and the density of rats in autumn is higher than that in spring. Rattus norvegicus is the main species of rats, with high virus carrying rate and infection rate.

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