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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(χ2=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(χ2=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 characteristics and control effects of hemorrhagic fever with renal syndrome (HFRS) before and after water storage in Dongjiang Lake reservoir area and provide a scientific basis for making prevention and control measures. Methods The data of HFRS epidemic and rodent surveillance in Zixing before and after water storage (1971-2014) in Dongjiang Lake were collected. Descriptive epidemiological methods were used to describe the incidence, mortality and the distribution of HFRS in three healthy population Serum antibody test results and host animal density, type, pathogen test results, the rate of comparison using χ2 test. Results The average incidence of HFRS in Zixing from 1971 to 2014 was 6.96 / lakh and the case fatality rate was 5.93%. The average annual incidence of HFRS (13.49 / lakh) after water storage (1987-2002) 1971-1986), the annual average incidence was 3.35 times (4.03 / 100,000); the highest incidence was in 1991 (the incidence was 40.63 / 100,000). There was a significant difference between the rat density (6.76%) and the rat density (9.40%) after water storage (from 1986 to 1987) (χ2 = 24.26, P = 0.00) 1987). The difference between the latent infection rate of HFRS in healthy population (24.66%) and the latent infection rate (2.66%) after water storage (2012) was statistically significant (χ2 = 31.67, P = 0.00). After the implementation of a comprehensive intervention model combining health education, deratization and vaccination from 1995 to 2014, the incidence rate dropped significantly. The incidence rate after 2006 was controlled between 0 and 1.10 / 100,000. Conclusions The local outbreak of HFRS occurred in Zixing City after the Dongjianghu Reservoir was impounded. The construction of epidemic and large-scale water conservancy projects may have a great impact on the epidemic of HFRS. The comprehensive intervention mode of combining health education, vaccination and rodent control is the main effective measure to prevent and control HFRS.