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目的通过分析2001-2010年监测资料,研究广州市肾综合征出血热(HFRS)的流行特征和变化趋势。方法应用描述性流行病学方法分析人间疫情监测、宿主动物监测资料,实验室应用间接免疫荧光法检测鼠血清HV特异性IgG抗体,直接免疫荧光法检测鼠肺汉坦病毒(HV)抗原。结果 2001-2010年共报告HFRS743例,死亡4例,发病率为0.81/10万,病死率为0.54%。发病人数和发病率呈现上升趋势,发病高峰在10月至次年6月,病例集中在天河区、海珠区和白云区,职业分布以工人、家务及待业、商业服务为主,其次是民工和农民。男女比例为3.10∶1,年龄集中在20～50岁。鼠密度为9.64%,鼠血清HV特异性IgG抗体阳性率为4.94%,鼠肺HV抗原阳性率为5.56%。鼠密度和鼠种构成相对稳定,但2004-2010年鼠血清HV特异性IgG抗体阳性率和鼠肺HV抗原阳性率均处于持续上升趋势。鼠种构成主要以褐家鼠(70.01%)为主,其血清HV特异性IgG抗体阳性率(6.02%)和肺HV抗原阳性率(6.58%)在各鼠种中最高。结论广州市HFRS疫情呈现一定的上升趋势,发病风险不断增大,应加强预防控制工作;另外,广州市可能已经由家鼠型疫区演变为混合型疫区,应寻找进一步的相关证据。
Objective To analyze the epidemiological characteristics and trends of hemorrhagic fever with renal syndrome (HFRS) in Guangzhou by analyzing the monitoring data from 2001 to 2010. Methods Descriptive epidemiological methods were used to analyze the data of human epidemiological surveillance and host animal monitoring. Indirect immunofluorescence assay was used to detect the serum HV specific IgG antibody in the laboratory, and the direct immunofluorescence assay was used to detect the Hantaan virus (HV) antigen in mouse lung. Results A total of 743 HFRS cases were reported from 2001 to 2010, with 4 deaths. The incidence rate was 0.81 / 100,000 and the case fatality rate was 0.54%. The incidence and incidence showed an upward trend, the peak incidence in October to June next year, the cases concentrated in Tianhe District, Haizhu District and Baiyun District, occupation distribution to workers, housework and unemployed, mainly commercial services, followed by migrant workers and Peasants. The ratio of males to females is 3.10: 1, and the age is between 20 and 50 years old. The rat density was 9.64%, the positive rate of mouse serum HV-specific IgG antibody was 4.94%, and the positive rate of mouse lung HV antigen was 5.56%. Rat density and the composition of the mice were relatively stable, but the positive rates of mouse serum HV-specific IgG antibody and mouse lung HV antigen in 2004-2010 were all on the rise. The majority of rodents were mainly Rattus norvegicus (70.01%). The serum HV-specific IgG antibody (6.02%) and lung HV antigen-positive rate (6.58%) were the highest in all species. Conclusion The epidemic situation of HFRS in Guangzhou shows a certain upward trend, and the risk of the disease is increasing. Therefore, the prevention and control work should be strengthened. In addition, Guangzhou may have evolved from a mouse-type epidemic area into a mixed type epidemic area. Further evidence should be sought.