Desvars Amélie, Furberg Maria, Hjertqvist Marika, Vidman Linda, Sjöstedt Anders, Rydén Patrik, Johansson Anders
Emerg Infect Dis. 2015 Jan;21(1):32-9. doi: 10.3201/eid2101.140916.
The zoonotic disease tularemia is endemic in large areas of the Northern Hemisphere, but research is lacking on patterns of spatial distribution and connections with ecologic factors. To describe the spatial epidemiology of and identify ecologic risk factors for tularemia incidence in Sweden, we analyzed surveillance data collected over 29 years (1984-2012). A total of 4,830 cases were notified, of which 3,524 met all study inclusion criteria. From the first to the second half of the study period, mean incidence increased 10-fold, from 0.26/100,000 persons during 1984-1998 to 2.47/100,000 persons during 1999-2012 (p<0.001). The incidence of tularemia was higher than expected in the boreal and alpine ecologic regions (p<0.001), and incidence was positively correlated with the presence of lakes and rivers (p<0.001). These results provide a comprehensive epidemiologic description of tularemia in Sweden and illustrate that incidence is higher in locations near lakes and rivers.
人畜共患疾病兔热病在北半球大片地区呈地方性流行，但缺乏关于其空间分布模式及与生态因素联系的研究。为描述瑞典兔热病发病情况的空间流行病学特征并确定其发病的生态危险因素，我们分析了29年（1984 - 2012年）间收集的监测数据。共报告了4830例病例，其中3524例符合所有研究纳入标准。在研究期间，从上半年到下半年，平均发病率增长了10倍，从1984 - 1998年的0.26/10万人增至1999 - 2012年的2.47/10万人（p<0.001）。在北方和高山生态区，兔热病发病率高于预期（p<0.001），且发病率与湖泊和河流的存在呈正相关（p<0.001）。这些结果提供了瑞典兔热病的全面流行病学描述，并表明在靠近湖泊和河流的地区发病率更高。
