【摘要】 目的分析2012年1月至2017年7月南京市肾综合征出血热(HFRS)的流行病学特征,为制定有效的防控策略和措施提供科学依据。方法收集2012年1月至2017年7月南京市人口信息和HFRS疫情监测数据,采用描述流行病学方法并结合Arc GIS 10. 2软件分析南京市的HFRS流行特征,包括时间分布、地区分布及人群分布。对比2017年1月至7月与前5年(2012年至2016年)同期的报告病例分布特征之间的差异,分析2017年南京市重点地区的疫情及疫情预警分析。结果 2012年1月1日至2017年7月31日,南京市累计报告HFRS病例220例,年均报告发病率为0. 45/10万。呈现双峰分布,春季(3月至6月)峰值[57. 3%(126/220)]高于冬季[12月至次年1月,19. 1%(42/220)]。高淳区报告病例数占全市的44. 1%(97/220),远高于南京市其他地区,病例主要分布于高淳区东部、北部以及与其相邻的溧水区部分乡镇。病例年龄中位数(四分位数间距)为48. 0(39. 0,60. 0)岁;以男性为主[68. 2%(150/220)]。职业分布以农民[59. 5%(131/220)]为主。2017年1月至7月与前5年(2012-2016年)同期相比,病例年龄增加[(52. 64±14. 23)岁比(46. 38±13. 85)岁,t=-2. 62,P <0. 05],溧水区报告病例数增加[11例(24. 4%)比13例(9. 3%),x2=6. 83,P <0. 05],其他特征差异无统计学意义。泊松(Poisson)检验结果显示,2017年1月至7月中,3月、5月以及7月发现传染病聚集的异常信号(均P <0. 05),但进一步核实现场调查未发现存在聚集性疫情。结论近年来南京市HFRS发病较平稳,发病高峰主要是高淳区和溧水区,青壮年男性和农民仍是该病暴露的高危人群,应加强对高发区及高危人群的监测。更多还原

【Abstract】 Objective To analyze the epidemic characteristics of hemorrhagic fever with renal syndrome( HFRS) in Nanjing City from January 2012 to July 2017,and to provide a basis for formulating better strategies for disease prevention and control. Methods Demographic data of populations and surveillance data of HFRS cases in Nanjing were collected from January 1,2012 to July 31,2017.Descriptive epidemiological method, combined with Arc GIS 10. 2, was used to explore epidemic characteristics of HFRS,including time,area and population distribution characteristics. The difference of epidemiological characteristics of HFRS were explored between the first 7 months of 2017 and the past 5 years( from 2012 to 2016). Epidemic situation was analyzed in high incidence areas of Nanjing in 2017.Forewarning analysis was performed to detect the probability of the aggregation epidemic. Results A total of220 HFRS cases were reported in Nanjing City,from January 1,2012 to July 31,2017,and the average annual incidence was 0. 45 cases per 100,000 persons. The incidence peaked twice annually and the value( 57. 3%) in spring( March to June) was higher than that( 19. 1%) in winter( December to January of next year). The cases from Gaochun District accounted for 44. 1% of the reported cases,which was far more than other districts of Nanjing,and most cases located in the eastern and northern areas of Gaochun District and some towns of Lishui District adjacent to Gaochun District. The median age and interquartile range was 48. 0( 39. 0,60. 0) years old. Among these cases,males accounted for 68. 2%,and farmers accounted for59. 5%. At the same time,the age of HFRS cases reported in the first 7 months of 2017 was older than that in the past five years( from 2012 to 2016)( t =-2. 62,P < 0. 05),and the number of HFRS cases from Lishui District increased in the first 7 months of 2017( 11 cases vs 13 cases,χ~2= 6. 83,P < 0. 05).Poisson distribution was used to probe the abnormal signals of epidemic situation in the first 7 months of 2017,and 3 abnormal signals( P < 0. 05) were found in three months( March,May,and July) without aggregation epidemic appeared by further epidemiological investigation. Conclusion The incidence of HFRS in Nanjing was stable in recent years. The majority of HFRS cases located in Gaochun district and Lishui district,young men and farmers were at high risk of the disease exposure. It was necessary to strengthen monitoring of the high-risk area and population.更多还原