2009-2014年云南省登革热流行病学调查与分析  

Epidemiological analysis and investigation of dengue fever in Yunnan Province from 2009 to 2014

作　　者：杨明东[1] 姜进勇[1] 郭晓芳[1] 吴超[1] 周红宁[1] 

机构地区：[1]云南省虫媒传染病防控研究重点实验室(筹备),云南省虫媒病毒研究中心,云南省寄生虫病防治所,云南普洱665099

出　　处：《中国病原生物学杂志》2015年第8期738-742,共5页Journal of Pathogen Biology

基　　金：国家自然科学基金项目(No.81160357,30960327,30660160)

摘　　要：目的分析云南省2009-2014年登革热流行特征,为登革热防控措施提供依据。方法收集云南省2009-2014年法定传染病报告系统中的登革热数据资料,采用描述性流行病学方法统计分析;采用RT-PCR检测登革病毒血清型和采用蚊虫幼虫采集法调查登革热媒介埃及伊蚊的分布。结果 2009-2014年云南省共报告登革热病例2 040例,其中本地感染病例1 579例,输入病例461例;在输入病例中,缅甸和老挝输入病例比例最高（占79.83%）;全年均有病例报告,8~11月为高发季节;病例主要集中于云南边境地区的西双版纳州（1 382例,占67.75%）和德宏州（562例,占27.55%）;男女比例为1.05∶1,各年龄组均有发病,以青壮年为主,20~59岁病例1 538例（占75.39%）,职业以商业服务、家务及待业、农民和学生为主,分别为523例（占25.64%）、224例（占10.98%）214例（占10.49）和200例（占9.80%）。对景洪市307份血清用RT-PCR和NS1抗原进行检测,两种方法吻合率在70%以上,NS1抗原检测方法敏感度为86.39%,特异度为57.76%;对瑞丽市73份血清用一步法实时荧光RT-PCR检测进行复核,NS1抗原检测方法敏感度为100%,特异度为91.67%;4个登革病毒血清型在云南均有发现,其中西双版纳州景洪市以登革病毒血清型Ⅲ型为主（99.50%）,德宏州瑞丽市以Ⅰ型为主（72.00%）;白纹伊蚊广泛分布,埃及伊蚊分布区扩大到9个边境县市。结论云南省登革热流行势态较为严峻,周边缅甸和老挝输入病例数逐年增加,媒介埃及伊蚊分布区域不断扩大,建议进一步加强云南边境地区登革热监测和媒介控制工作。Objective To analyze and investigate characteristics and outbreaks of dengue fever in Yunnan Province from2009 to 2014in order to providing evidence for dengue prevention and control. Methods Data on outbreaks of dengue fever in Yunnan Province from 2009-2014 were collected from the prescribed system for reporting infectious diseases,and those data were analyzed using descriptive epidemiology.The dengue serotype was detected with RT-PCR and the distribution of Aedes aegypti was investigated by collecting mosquito larvae. Results In total,2 040 cases of dengue fever were reported in Yunnan from 2009 to 2014.Of those,1 579 were autochthonous and 461 were imported.Most of the imported cases were imported from Laos and Myanmar（accounting for 79.83% of all imported cases）.Cases were reported year-round,but the peak season for dengue fever was from August to November.Cases were mainly distributed in the prefectures of Xishuangbanna and Dehong（1 944 cases,accounting for 95.30% of all cases of dengue fever）in the border areas of Yunnan.The ratio of affected males to females was 1.05：1.Cases of dengue fever were reported in every age group,but most involved individuals ages 20-59（accounting for 75.39% of all cases）.In terms of occupation,affected individuals were mostly in the service industry（25.64%）,homemakers or unemployed（10.98%）,farmers（10.49%）,and students（9.80%）.Three hundred and seven serum samples from the city of Jinghong were subjected to RT-PCR and tested for the NS1 antigen.Results indicated that the rate of concordance between these two methods was above 70%.Testing for the NS1 antigen had a sensitivity of 86.39% and a specificity of 57.76%.Seventy-three serum samples from the city of Ruili were subjected to one-step real-time RT-PCR to test for the NS1 antigen,and this method had a sensitivity of 100% and a specificity of 91.67%.Four dengue serotypes were found in Yunnan Province.The most predominant was DEN-3in the city of Jinghong,Xishuangbanna Prefecture and DEN-1in the city

关 键 词：登革热 流行病学 埃及伊蚊 云南省 

分 类 号：R512.8[医药卫生—内科学]