目的 了解1971—2011年湖北省肾综合征出血热(HFRS)的发病及流行趋势,为制定预防措施提供科学依据。方法 收集湖北省1971—2011年历年传染病统计报表和人口资料,利用Excel、SPSS13.0和MapInfo软件进行图表和数据的统计处理。结果 1971—2011年,湖北省肾综合征出血热发病率波动在0.28/10万~49.50/10万之间,年平均发病率为7.99/10万,年平均死亡率为0.48/10万,平均病死率为5.91%。41年出现2个明显发病周期,1988年之后发病率趋于稳定。41年间,湖北省HFRS秋冬峰(10月~次年1月)和春夏峰(3月~6月)发病例数的比值发生了2次较为明显的改变。1971年至1982年,比值维持在一个较高水平,为5~10;1982-1986年,比值由最大值9.1下滑至2.2;1987-1995年,比值维持在2~4;1996-2009年,比值在1左右波动。70年代,疫区主要分布于武汉及其周边地区,随后高发疫区有所转移,现主要集中在襄阳、荆门、荆州的某些局部区域。在人群分布上,历年发病男性多于女性,以农民为主。随着时间推移,40~59岁和60岁及以上者发病人数所占比例逐渐增高,15~39岁所占比例逐渐下降。结论 1971—2011年,湖北省HFRS发病率经过两个发病周期之后,逐渐降低并趋于稳定。流行季节性在80年代中期和90年代中期发生转变,秋冬峰与春夏峰发病人数的差距缩小。疫区也发生变迁。疫区类型可能由以姬鼠型为主向混合型演变。

We investigated the characteristics of long-term trend of hemorrhagic fever with renal syndrome (HFRS) incidence from 1971 to 2011 in Hubei, China and provided scientific basis for developing preventive measures. Statistical reports of HFRS and demographic data from 1971 to 2011 were collected. Excel, SPSS13.0 and MapInfo software were used to analyze these data and produce diagram. Results showed that from 1971 to 2011, the range of HFRS incidence fluctuated between 0.28/100 000 and 49.50/100 000. The average yearly incidence rate was 7.99/100 000 and the mortality rate was 0.48/100 000, the average fatality rate was 5.91%. Two distinct disease cycles appeared in the epidemic duration, and the incidence rates became stable after 1988. Most cases occurred between October and next January or between March and June. However, the seasonality of HFRS has changed over years. The ratio of cases in the two peaks maintained at a high level between 5 and 10 from 1971 to 1982; then it decreased to 2.2 in 1986 from 9.1 in 1982; it maintained at a level between 2 to 4 from 1987 to 1995, and kept around 1 from 1996 to 2009. In 1970s, high epidemic areas were mainly distributed in Wuhan City and surroundings. But it changed over time and now the high epidemic areas were mainly distributed in local areas within Xiangyang, Jingmen and Jingzhou cities. In terms of population distribution, more male were infected with HFRS than female and peasants were a high-risk population. Age distribution changed over time with the proportion of cases aged 40 or older gradually increasing and the proportion of cases aged 15-39 years decreasing. These results indicated that during the year from 1971 to 2011, the incidence rate of HFRS in Hubei gradually reduced and tended to be stable after two distinct cycles. The seasonality of HFRS had changed in middle 80’s and middle 90’s, with the gap between two peaks being narrowing. The epidemic areas had changed over time. The epidemic areas type possibly changed from Apodenmus agrarius playing the dominant role to mixed type that Apodenmus agrarius and house mouse being dominant simultaneously.