东江湖库区蓄水前后资兴段肾综合征出血热流行特征及防控效果分析  

Epidemiological characteristics and prevention and control effects of hemorrhagic fever with renal syndrome in Zixing section before and after the water storage of the Dongjiang reservoir

作　　者：袁国林 夏云磊[2] 李雄豹 黎利文 李焕剑 

机构地区：[1]湖南省资兴市卫生局农村卫生管理站,湖南资兴423400 [2]资兴市疾病预防控制中心

出　　处：《实用预防医学》2016年第8期938-942,共5页Practical Preventive Medicine

摘　　要：目的 分析东江湖库区蓄水前后资兴段肾综合征出血热（HFRS）的流行特征及防控效果,为制定防控措施提供科学依据。方法 收集东江湖库区蓄水前后（1971-2014年）资兴市HFRS疫情和鼠类监测资料,用描述性流行病学方法描述HFRS的发病率、死亡率、病例的三间分布、健康人群血清抗体检测结果以及宿主动物的密度、种类、病原体检测结果等,率的比较采用χ2检验。结果 资兴市1971-2014年HFRS年均发病率为6.96/10万,病死率为5.93%;蓄水后（1987-2002年）的年均发病率（13.49/10万）是蓄水前（1971-1986年）的年均发病率（4.03/10万）的3.35倍;发病最高峰在1991年（发病率40.63/10万）。蓄水前（1986-1987年）鼠密度（6.76%）与蓄水后（1994年）鼠密度（9.40%）差异有统计学意义（χ^2=24.26,P=0.00）;蓄水前（1986-1987年）健康人群HFRS隐性感染率（24.66%）与蓄水后（2012年）隐性感染率（2.66%）差异有统计学意义（χ^2=31.67,P=0.00）。1995-2014年实施健康教育、灭鼠和疫苗接种相结合的综合干预模式后,发病率显著下降,2006年以后发病率一直控制在0-1.10/10万之间。结论 东江湖水库蓄水后资兴市出现了HFRS的局部暴发、流行,大型水利工程的兴建对该病的流行可造成较大影响。采取健康教育、预防接种和灭鼠防鼠相结合的综合干预模式是防控HFRS的主要有效措施。Objective To analyze the epidemiological features and prevention and control effects of hemorrhagic fever with renal syndrome（HFRS） in Zixing section before and after the water storage of the Dongjiang Reservoir so as to provide a scientific basis for developing prevention and control measures.Methods We collected HFRS epidemic and rodent monitoring data in Zixing City before and after the water storage of the Dongjiang Reservoir during 1971-2014.Descriptive epidemiologcial methods were used to describe the incidence rates,mortalities and case distribution（regarding time,region and population） of HFRS,serum antibody test results of healthy people,as well as densities,species and pathogen detection results of host animals.Results The average annual incidence rate and case fatality rate of HFRS in Zixing City during 1971-2014 were 6.96/100,000 and5.93%,respectively.The annual average incidence rate after the water storage（in 1987-2002） was 3.35 times that before the water storage（in 1971-1986）（13.49/100,000 vs.4.03/100,000）.The peak incidence was in 1991（40.63/100,000）.The mouse densities before the water storage（in 1986-1987） and after the water storage（in 1994） were significantly different（6.76% vs.9.40%,χ^2= 24.26,P = 0.00）.The recessive infection rate of HFRS in healthy population before the water storage（in 1986-1987） was significantly higher than that after the water storage（in 2012）,with a statistically significant difference（24.66% vs.2.66%,χ^2= 31.67,P = 0.00）.The incidence rates of HFRS decreased significantly after implementing the comprehensive intervention model concerning health education,deratization and vaccine inoculation from 1995 to 2014,and the incidence rates had been maintained at 0-1.10/100,000 since 2006.Conclusions There are epidemic outbreaks of HFRS in Zixing City after the water storage in the Dongjiang reservoir;and hence,establishing large water conservancy projects can significantly affect the prevalence of HFRS.Adopting the integrated

关 键 词：水库 肾综合征出血热 流行特征 防控效果 

分 类 号：R512.8[医药卫生—内科学]