| Objective To understand the epidemiological characteristics of hemorrhagic fever with renal syndrome(HFRS)in Hubei province.To study the surveillance data of mouse population community,density and toxin-carrying rate of rodents.To explore the risk factors of HFRS in Hubei Province,so as to provide guidance for disease prevention and control.Methods Annual report of the legal infectious diseases in Hubei Province,HFRS case data from China Information System for Disease Control and Prevention and sentinel surveillance data were collected.The epidemic characters of HFRS were analyzed by descriptive statistical method and geographic information system(Maplnfo).Select the high incidence areas of Hubei Yicheng,Zhongxiang,Tianmen,Qianjiang,Xiantao and Jianli County as the investigation point,collect the population characteristics data of in reported natural villages of HFRS in 2015.A residents questionnaire survey was conducted in the above six regions.In every region,1 case natural village was randomly selected as the case group to investigate 30 households,1 non-case natural village which was adjacent to and at the same township with the case natural village was selected as the control group to investigate 30 households.The information of digestive tract factors,contact history,aerosol factors,housing conditions,family members and family members history of hemorrhagic fever with renal syndrome were collected.SPSS20.0 was used to to analyzed risk factors by univariate and multivariate logistic regression analysis.Results A total of 4943 cases were reported from 94 counties in the 16 cities in Hubei Province during 2001-2015,including 139 death cases,with an average incidence rate of 0.5642 per100 thousands,with an average mortality rate was 3.04%.The cases were mainly distributed in the rural areas of central,whose landforms were mainly plains and hills.HFRS cases occurred in every months with double epidemic peaks,the spring and summer peak(April to July)and the autumn and winter peak(October to the following January).The proportion of cases in autumn and winter peak(43.7%)was slightly higher than spring and summer peak(37.8%).The population distributive characteristics of reported cases from 2004 to2015 were as follow,mainly cases was in the middle age(40-59 years old),accounting for 53.04%.Male were more than female,the sex ratio was 3.11:1.The largest number of cases were farmers,accounting for 75.87% of the total number.Rattus norvegicus and apodemus agrarius were dominant in the constitution of host animals.The average rat density in the residential area was higher than in the wild,and the difference was statistically significant(X~2=311.345,P<0.001).The average rat density in autumn was higher than in spring,and the difference was statistically significant(X~2=20.972,P<0.001).There was a high linear correlation between the average incidence of the whole province and the toxin-carrying rate in mice(r=0.985).Pathogen monitoring results showed that,Apodemus agrarius mainly carried Hantaan virus and Sewer rat carried Seoul virus.Hubei rural resident population and the labor force of the resident population was mainly concentrated in the elderly(40-69 years old),accounting for 50.19% and 68.23% respectively.The incidence rate of 40-69 years old age group in rural resident population was higher than that of other age groups(X~2=31.045,P<0.001).The incidence of male was higher than that of female(X~2=28.297,P<0.001).The results of univariate logistic regression indicated that well-preserved walls and kitchen with good sanitary condition were two protective factors.Occasionally non-cleaning of fruits and vegetables for eating,contacting with rodents or kill mice in the past year,taking rats,contacting with rat fecal,occasionally sitting near the rat holes,often sitting on grass,the residence adjacent to threshing ground and the residence adjacent to river or canal were risk factors.The results of multivariate logistic regression indicated that occasionally non-cleaning of fruits and vegetables for eating,taking rats,often sitting on grass,the residence adjacent to threshing ground and the residence adjacent to river or canal were risk factors.Conclusions There was a high linear correlation between the average incidence of the whole province and the toxin-carrying rate in mice.Middle aged and elderly population was the focus of disease prevention and control in the future.It was necessary to further strengthen the monitoring of human disease,rat density and toxin-carrying rate in mice,together with comprehensive rodent control work.Also,we should strengthen publicity and education about disease knowledge and protection knowledge,so as to get better prevention and control of epidemic of hemorrhagic fever with renal syndrome. |
