Chen Q L, Zhu M T, Chen N, Yang D, Yin W W, Mu D, Li Y, Zhang Y P, Zainawudong Yushan
Key Laboratory of Surveillance and Early-warning on Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
School of Public Health, Guangxi Medical University, Nanning 530000, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2022 Jun 10;43(6):852-859. doi: 10.3760/cma.j.cn112338-20220325-00228.
To analyze the epidemiological characteristics of severe fever with thrombocytopenia syndrome (SFTS) in China from 2011 to 2021, and provide evidence for the prevention and control of SFTS. The incidence data of SFTS were collected from the National Disease Reporting Information System of Chinese Center for Disease Control and Prevention for a descriptive epidemiological analysis and Cochran-Armitage trend test was used to evaluate the association between age and the morbidity rate and case fatality rate (CFR) of SFTS. From 2011 to 2021, a total of 18 902 laboratory confirmed cases of SFTS, including 966 deaths, were reported in 533 counties (districts) of 154 prefecture-level cities in 27 provinces. The annual average morbidity rate was 0.125/100 000, and the annual average CFR was 5.11%. From 2011 to 2021 the overall morbidity rate of SFTS was in increase with an average annual percentage change (AAPC) of 14.80% (=0.001). Most cases (99.23%) occurred in 7 provinces, including Shandong, Henan, Anhui, Hubei, Liaoning, Zhejiang and Jiangsu, with 70.28% of the cases in 11 prefecture-level cities. The average annual CFRs in the 7 provinces varied greatly from 1.30% to 11.27%. In 2011, SFTS cases were reported in 108 counties (districts) of 51 prefecture-level cities in 13 provinces, but SFTS cases were reported in 277 counties (districts) of 88 prefecture-level cities in 19 provinces in 2021, the disease spread from central area to the northeast and from the west and the south. SFTS mainly occurred in summer and autumn in both southern and northern China, and 96.63% of the cases were reported from April to October, and the incidence peak was during May-June. The cases mainly occurred in age group 50-74 years (69.46%), and the deaths mainly occurred in age group ≥60 years (79.71%). Both the morbidity rate and the CFR increased with age. The morbidity rate increased from 0.040/100 000 in age group 0-4 years to 4.480/100 000 in age group ≥80 years in males (²=13 185.21, <0.001) and from 0.038/100 000 in age group 0-4 years to 3.318/100 000 in age group ≥80 years in females (²=12 939.83, <0.001); the CFR increased from 0.70% in age group 30-34 years to 11.58% in age group ≥80 years in males (²=115.70, <0.001) and from 1.56% in age group 35-39 years to 8.98% in age group ≥80 years in females (²=103.42, <0.001). From 2011 to 2021, the incidence of SFTS increased in China, and the spread and obvious spatiotemporal distribution of SFTS were observed. The reported CFR varied greatly with area, and both the morbidity and mortality risk were high in the elderly.
分析2011年至2021年中国重症发热伴血小板减少综合征（SFTS）的流行病学特征，为SFTS的防控提供依据。从中国疾病预防控制中心国家疾病报告信息系统收集SFTS的发病数据进行描述性流行病学分析，并采用 Cochr an-Armitage趋势检验评估年龄与SFTS发病率和病死率（CFR）之间的关联。2011年至2021年，27个省154个地级市的533个县（区）共报告18902例实验室确诊的SFTS病例，其中966例死亡。年平均发病率为0.125/10万，年平均CFR为5.11%。2011年至2021年，SFTS总体发病率呈上升趋势，平均年变化百分比（AAPC）为14.80%（=0.001）。大多数病例（99.23%）发生在7个省份，包括山东、河南、安徽、湖北、辽宁、浙江和江苏，其中11个地级市的病例占70.28%。这7个省份的年平均CFR差异很大，从1.30%到11.27%不等。2011年，13个省51个地级市的108个县（区）报告了SFTS病例，但2021年19个省88个地级市的277个县（区）报告了SFTS病例，疾病从中心地区向东北以及西部和南部传播。中国南方和北方的SFTS主要发生在夏秋季节，96.63%的病例在4月至10月报告，发病高峰在5月至6月。病例主要发生在50 - 74岁年龄组（69.46%），死亡主要发生在≥60岁年龄组（79.71%）。发病率和CFR均随年龄增长而升高。男性发病率从0 - 4岁年龄组的0.040/10万增加到≥80岁年龄组的4.480/10万（χ² = 13185.21，P < 0.001），女性从0 - 4岁年龄组的0.038/10万增加到≥80岁年龄组的3.318/10万（χ² = 12939.83，P < 0.001）；男性CFR从30 - 34岁年龄组的0.70%增加到≥80岁年龄组的11.58%（χ² = 115.70，P < 0.001），女性从35 - 39岁年龄组的1.56%增加到≥80岁年龄组的8.98%（χ² = 103.42，P < 0.001）。2011年至2021年，中国SFTS发病率上升，观察到SFTS的传播及明显的时空分布。报告的CFR因地区差异很大，老年人的发病和死亡风险均较高。
