Luo Lei, Liang Hui-ying, Hu Yu-shan, Liu Wei-jia, Wang Yu-lin, Jing Qin-long, Zheng Xue-li, Yang Zhi-cong
School of Public Health and Tropical Medicine of South Medical University, No.1838, North Road Avenue, Guangzhou, Guangdong Province 510515, PR China.
J Vector Ecol. 2012 Jun;37(1):230-40. doi: 10.1111/j.1948-7134.2012.00221.x.
To understand its unprecedented resurgence, we examined the epidemiological, virological, and entomological features of dengue in Guangzhou during 1978-2009. Cases reported to the Guangzhou Centre for Disease Control and Prevention and data from virological and entomological surveillance were analyzed from three periods: 1978-1988, 1989-1999, and 2000-2009. Although cases decreased over time: 6,649 (1978-1988) to 6,479 (1989-1999) to 2,526 (2000-2009), geographical expansion resulted in districts with an average incidence >2.5/100,000, increasing from five (1978-1988, 1989-1999) to seven (2000-2009). Age distribution (mean age: 34.9 years) provided a trend of increasing dengue incidence among adults, and there was a significantly higher incidence among men with a sex ratio of 1.15:1 (P<0.001). Cases occurred from May through November with a peak between August and October, and a long-term trend was characterized by a three to five-year cyclical pattern. The most frequently isolated serotypes were DENV-2 (1978-1988) and DENV-1 (1989-1999 and 2000-2009). Seasonal fluctuations in immature densities of Aedes albopictus (sole transmission vector in Guangzhou) were consistent with the dengue seasonality. After a 30-year apparent absence, DENV-3 had reemerged in 2009. The current epidemiological situation is highly conducive to periodic dengue resurgences. Thus, a high degree of surveillance and strict control measures in source reduction should be maintained.
为了解登革热疫情前所未有的再度流行情况，我们研究了1978 - 2009年期间广州登革热的流行病学、病毒学和昆虫学特征。分析了向广州市疾病预防控制中心报告的病例以及来自病毒学和昆虫学监测的数据，研究分三个时期：1978 - 1988年、1989 - 1999年和2000 - 2009年。尽管病例数随时间减少：从1978 - 1988年的6649例降至1989 - 1999年的6479例，再降至2000 - 2009年的2526例，但地理范围的扩大导致平均发病率>2.5/10万的区从五个（1978 - 1988年、1989 - 1999年）增加到七个（2000 - 2009年）。年龄分布（平均年龄：34.9岁）显示成人登革热发病率呈上升趋势，男性发病率显著更高，性别比为1.15:1（P<0.001）。病例发生在5月至11月，8月至10月达到高峰，长期趋势呈现三到五年的周期性模式。最常分离出的血清型在1978 - 1988年为登革病毒2型（DENV - 2），在1989 - 1999年和2000 - 2009年为登革病毒1型（DENV - 1）。白纹伊蚊（广州唯一的传播媒介）幼虫密度的季节性波动与登革热季节性一致。在明显消失30年后，登革病毒3型（DENV - 3）于2009年再度出现。当前的流行病学形势极有利于登革热的周期性再度流行。因此，应保持高度监测并采取严格的源头控制措施。
