| Objective:In recent years,the epidemic situation of hemorrhagic fever with renal syndrome(HFRS)in Guanyun county has been maintained at a high level.The number of cases ranked the first in Lianyungang city,showing a highly epidemic trend.This study aims to further understand the epidemiological regularity and influencing factors of HFRS in epidemic area,meanwhile provide information for the formulation of prevention and control police by analyzing the Serum antibody level in host animals and healthy people in Guanyun county from 2015 to 2017 and the epidemiological characteristics of HFRS patients from 2013 to 2017.Methods:Data was collected from incidence reports,reported in great epidemic network and host animal monitoring of HFRS.The epidemiological characteristics of HFRS were analyzed by descriptive statistics,and investigation of reservoir animals was conducted in Xiaoyi,Nangang and Tongxing town,respectively.Each confirmed case of HFRS reported by China Information System for Disease Control and Preventionwas matched with 2 control cases to investigate the risk factors.Univariate and multivariate conditional logistic regression were conducted by SPSS18.0.Results: 1.Epidemic characteristics of HFRS There were a total of 244 confirmed cases in Guanyun county from 2013 to 2017,including 9 deaths.The annual morbidity was 4.68/100,000,the mortality rate was 0.17/100,000,and the case fatality rate was 3.69%.The overall incidence first rose and then descended,and reached its lowest point in 2005.During the period of 2013-2017,19 towns of the county all reported HFRS cases.The top 6 towns with bigger number of reported cases were:Xiao-yi township(27 cases),Nangang township(24 cases),Yishan township(22 cases),Dragon township(21 cases),Dongwangji township(18 cases),Yangji township(18 cases).The cumulative number of cases was 130,accounting for 53.28%(130/240)of the total number of HFRS cases reported in the county.The cases were mainly distributed in the midwestand west of Guanyun county,while the cases in the east were relatively scattered.From 2013 to 2017,the annual epidemic season of HFRS were autumn and winter(October to January of the following year).The cases(190)reported in epidemic peak of autumn and winter accounted for 77.87% of the total cases.The figurein spring and summer was relatively stable,ranging from 0 to 10,with unobvious epidemic trend.There were 209 HFRS patients aged between 30 and 69 years,accounting for 85.66% of the total cases.Among them,60-69 age group was the highest(30.33%).The lowest incidence appeared in 10-19 and ≥80 age group.There were 186 male patients and 58 female patients,and the male-female ratio was 3.21.The incidence rate of male(6.79/100,000)was higher than female(2.64/100,000).Farmers constituted the largest proportion(90.57%)of the total,followed by housework and unemployed people,which together account for 3.28%.2.Host status Musmusculus,R.flavipectus and Apodemusagrarius are three main rodents species in Guanyun county.There was statistically significant difference(χ2=3.922,P=0.048)in the average rodent sdensity between the field and residential area,which were 3.75%(72/1920)and 2.62%(50/1905)respectively.The virus rates of rodents was 3.13%,and the highest proportion was Apodemusagrarius,followed by R.flavipectus and Mus musculus.The virus rates of rodents in autumn was 4.10%(10/244),which was higher than that in spring 2.24%(6/268).There was no statistical difference between them(χ2=1.459,P=0.227).3.Serum antibody monitoringin healthy population The results of serum antibody test in healthy people showed that the positive rate was 3.44%.4.Analysis of influencing factors Univariate conditional logistic regression analysis showed that carrying out deratization and ratproofing in residences,neversiting and lying by the ditch farm are two protective factors of HFRS.Smaller household size,houses with spare rooms,houses surrounded by crops,houses adjacent to a pond or stream,houses with rat holes,houses with rodents,workplaces with rodents or their dropping,residences raising livestock,residences raising poultry,never or occasionally eatingheated leftovers,siting and lying by the ditch farm frequently,damaged skin,bitten or scratched by a cat or dog and contacting with rodents or their droppingswere all risk factors of HFRS.Multivariate conditional logistic regression analysis showed that houses adjacent to a pond or stream,work places with rodents or their dropping,residences raising livestock,never or occasionally eating heated leftovers,sitting and lying by the ditch farm and contacting with ratsor their droppings were risk factors of HFRS.Conclusion: The rodents density and virus rates of rodents were both high in Guanyun county.Farmers,young and middle-aged people are the focus of HFRS prevention and control in Guanyun county.In the future prevention and control work.the monitoring of rodents density and virus rates of rodents,and the epidemic surveillance should be strengthened.Carrying out vaccination for high-risk people in key areas are also significant.In this way,people will understand the related knowledge and know how to defend,change bad eating habits,living habits and production habits.Consequently,the goal of reducing the incidence of HFRS is achieved. |
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