周宁县肾综合征出血热防制研究报告

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周宁县1973~1993年发生肾综合征出血热320例,年发病率波动在0.76~24.44/10万,年均发病率10.24/10万;死亡13例,病死率4.06%,病例分布于除咸村镇之外的8个乡镇67个村。疫情相对集中,狮城镇发病占总病例数的40.31%。季节分布呈单峰型,流行高峰在11~12月。发病以青壮年为主,男女之比为3.57:1,农民发病占62.5%。检查恢复期病人血清112份,阳性率为92.85%;检测疫区健康人群血清254份,隐性感染率为0.79%,调查疫区鼠类5215只,发现6种鼠类携带病毒,以黑线姬鼠带病毒率最高(4.05%),其次为褐家鼠(2.56%);并从人和鼠中分离到野鼠型病毒株。监测证实,主要传染源是黑线姬鼠和褐家鼠,疫区类型是以姬鼠型为主的混合型疫源地。自1991年开展控制效果研究以来,每年在疫区进行两次灭鼠,使室内、外鼠密度比灭鼠前分别下降63.98%和58.13%,带病毒率下降65.85%,发病率比灭鼠前18年年均下降49.96%,与灭鼠前3年相比下降69.27%。监测发现,黑线姬鼠、褐家鼠和黄毛鼠的带病毒鼠指数与发病相关,可作为效果考核与预测指标。 Zhou Ning County, from 1973 to 1993, 320 cases of hemorrhagic fever with renal syndrome occurred, the annual incidence of fluctuations in the 0.76 ~ 24.44 / 100,000, the average annual incidence of 10.24 / 100,000; 13 cases of death, the case fatality rate of 4.06% 67 villages in 8 towns outside the village. Relatively concentrated epidemic situation, the incidence of lion cities accounted for 40.31% of the total number of cases. Seasonal distribution showed a single peak, the peak in 11 to December. Incidence of young adults, male to female ratio of 3.57: 1, incidence of 62.5% of farmers. A total of 112 serum samples from convalescent patients were tested, with a positive rate of 92.85%; 254 serum samples from healthy subjects in the epidemic area were detected, with a recessive infection rate of 0.79%. 5215 rodents were investigated in the affected areas and 6 rodents were found to carry the virus, Apodemus virus with the highest rate (4.05%), followed by Rattus norvegicus (2.56%); and isolated from human and mouse wild-type virus strains. Surveillance confirmed that the main source of infection is Apodemus and Rattus norvegicus, the type of epidemic area is mainly based on the type of mixed murine Apodemus. Since 1991, the control effect study has been conducted in the affected area twice a year, so that the density of indoors and outdoors rats decreased 63.98% and 58.13% respectively compared with that before decontamination, with the virus rate decreased 65.85% The average annual decline in 18 years was 49.96%, a decrease of 69.27% ​​compared with that in the first 3 years. Monitoring found that Apodemus agkistrodon, Rattus norvegicus and Rattus rat viral mouse index associated with the incidence, can be used as an indicator of effectiveness assessment and prediction.
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