Ehlkes Lutz, Eastwood Keith, Webb Cameron, Durrheim David
Hunter New England Population Health, Newcastle, Australia .
Western Pac Surveill Response J. 2012 Aug 2;3(3):63-8. doi: 10.5365/WPSAR.2012.3.1.004. Print 2012 Jul.
Barmah Forest virus (BFV) is a mosquito-borne virus causing epidemic polyarthritis in Australia. This study used case follow-up of cases from the surveillance system to demonstrate that routinely collected BFV notification data were an unreliable indicator of the true location of exposure.
BFV notifications from June 2001 to May 2011 were extracted from the New South Wales (NSW) Notifiable Conditions Information Management System to study case distribution. Disease cluster analysis was performed using spatial scan statistics. Exposure history data were collected from cases notified in 2010 and 2011 to accurately determine travel to high-risk areas.
Cluster analysis using address data identified an area of increased BFV disease incidence in the mid-north coast of NSW contiguous with estuarine wetlands. When travel to this area was investigated, 96.7% (29/30) cases reported having visited coastal regions within four weeks of developing symptoms.
Along the central NSW coastline, extensive wetlands occur in close proximity to populated areas. These wetlands provide ideal breeding habitats for a range of mosquito species implicated in the transmission of BFV. This is the first study to fully assess case exposure with findings suggesting that sporadic cases of BFV in people living further away from the coast do not reflect alternative exposure sites but are likely to result from travel to coastal regions. Spatial analysis by case address alone may lead to inaccurate understandings of the true distribution of arboviral diseases. Subsequently, this information has important implications for the collection of mosquito-borne disease surveillance information and public health response strategies.
巴马森林病毒（BFV）是一种通过蚊子传播的病毒，在澳大利亚可引发流行性多关节炎。本研究通过对监测系统中的病例进行随访，以证明常规收集的BFV通报数据并不能可靠地指示实际暴露地点。
从新南威尔士州（NSW）法定传染病信息管理系统中提取2001年6月至2011年5月期间的BFV通报，以研究病例分布情况。使用空间扫描统计方法进行疾病聚类分析。收集2010年和2011年通报病例的暴露史数据，以准确确定前往高风险地区的行程。
利用地址数据进行的聚类分析确定，新南威尔士州中北部海岸与河口湿地相邻的一个区域BFV疾病发病率有所上升。在对前往该地区的行程进行调查时，96.7%（29/30）的病例报告在出现症状的四周内去过沿海地区。
在新南威尔士州中部海岸线沿线，大量湿地紧邻人口密集区。这些湿地为一系列与BFV传播有关的蚊子提供了理想的繁殖栖息地。这是第一项全面评估病例暴露情况的研究，研究结果表明，居住在远离海岸地区的人感染BFV的散发病例并非反映了其他暴露地点，而很可能是前往沿海地区所致。仅根据病例地址进行空间分析可能会导致对虫媒病毒疾病真实分布的不准确理解。因此，这一信息对于蚊媒疾病监测信息的收集以及公共卫生应对策略具有重要意义。
