Settergren B, Juto P, Wadell G, Trollfors B, Norrby S R
Dept. of Infectious Diseases, U. of Umeå, Umeå U. Hospital, Sweden.
Am J Epidemiol. 1988 Apr;127(4):801-7. doi: 10.1093/oxfordjournals.aje.a114862.
A nationwide survey of hospitalized, serologically verified adult nephropathia epidemica cases in Sweden from 1978 to 1981 was performed. Serum was collected from 1,063 patients with a diagnosis of nephropathia epidemica or one of 10 other renal diseases with related symptoms. Sera were analyzed by indirect immunofluorescence technique for the presence of immunoglobulin G antibodies to Hantaan virus, causative agent of Korean hemorrhagic fever that cross-reacts with the nephropathia epidemica agent. Antibodies were present in 368 patients, 355 of whom also fulfilled four or more of six criteria for clinical diagnosis of nephropathia epidemica. The male:female ratio was 2.7:1. The total number of cases in Sweden varied between 26 and 144 per year, which coincided with the fluctuations in small rodent populations. The highest incidence was found in Västerbotten County, with a maximum crude incidence rate of 23.5 cases per 100,000 inhabitants per year. Mean crude incidence in Sweden during the study period was 1.3 cases per 100,000 inhabitants per year. The southernmost cases lived in proximity to the 59th parallel. Thus, nephropathia epidemica was found to be prevalent south of the 60th parallel, which was previously assumed to be its southern boundary.
对1978年至1981年瑞典全国范围内住院治疗且经血清学确诊的成人流行性肾病病例进行了调查。从1063名被诊断为流行性肾病或患有其他10种伴有相关症状的肾脏疾病之一的患者中采集了血清。采用间接免疫荧光技术分析血清中针对汉坦病毒的免疫球蛋白G抗体的存在情况，汉坦病毒是韩国出血热的病原体，与流行性肾病病原体存在交叉反应。368名患者体内存在抗体，其中355名患者还符合流行性肾病临床诊断六项标准中的四项或更多项。男女比例为2.7:1。瑞典每年的病例总数在26例至144例之间波动，这与小型啮齿动物种群数量的波动相一致。发病率最高的是西博滕省，每年每10万居民中的最高粗发病率为23.5例。研究期间瑞典的平均粗发病率为每年每10万居民1.3例。最南端的病例居住在北纬59度附近。因此，发现流行性肾病在北纬60度以南地区流行，而此前认为北纬60度是其南部边界。
