Changes in age distribution of hemorrhagic fever with renal syndrome: an implication of China’s expanded program of immunization

BMC Public Health

Xiaofang Wang¹  Xiaoxia Huang¹  Shiwen Wang¹  Xiaozhou He¹ 

[1] National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China

关键词: China;    Age distribution;    Expanded program of immunization;    Hemorrhagic fever with renal syndrome;   

Others  :  1162287
DOI  :  10.1186/1471-2458-13-394

 received in 2012-10-23, accepted in 2013-04-19,  发布年份 2013

【 摘 要 】

Background

Vaccination against hemorrhagic fever with renal syndrome (HFRS) has been applied successfully for more than 20 years in China, and since 2008, the government has implemented the Expanded Program of Immunization (EPI) in regions with high incidence. In this study, we analyzed the EPI-related changes in age distribution in reported cases of HFRS and proposed new recommendations for prevention and control of the disease.

Methods

Data relating to incidence of HFRS, geographical location and age distribution were collected through the China Information System for Disease Control and Prevention (CISDCP) from 2005 to 2010. Excel and SPSS 18.0 software, χ2 tests and descriptive methodology were used for analysis of the data.

Results

A total 75 434 HFRS cases were reported in 28 provinces in China between 2005 and 2010. The majority of HFRS cases occurred in adults aged 30 to 55 and this group accounted for 68.3% of the total. With the implementation of the immunization program, HFRS age distribution has clearly changed in recent years. The proportion of HFRS cases among individuals targeted by EPI (16–60 years of age) decreased from 86.9% in 2005 to 81.9% in 2010. However, the proportion of cases among the non-vaccinated group aged <16 and >60 had increased from 13.1% in 2005 to 18.1% in 2010. Notably, in the >60 age group the proportion rose from 8.8% in 2005 to 14.7% in 2010. These differences were statistically significant.

Conclusion

HFRS vaccination has played an important role in HFRS control and prevention in China. However, since the proportion of HFRS cases over 60 years old has increased significantly since EPI was implemented, it is recommended that the age limit for vaccination be reconsidered. This finding may have practical implications for more effective HFRS vaccination in the future.

【 授权许可】

   
2013 He et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Lee PW, Amyx HL, Gibbs CJ Jr, Gajdusek DC, Lee HW: Propagation of Korean hemorrhagic fever virus in laboratory rats. Infect Immun 1981, 31(1):334-338.
• [2]Wang SW, Hang CS, Wang H, Xie YX, Ma BJ: Genotype and clade distribution of hantaviruses in china. Chin J Virol 2002, 18(3):211-216.
• [3]Zhang YZ, Zou Y, Fu ZF, Plyusnin A: Hantavirus infections in humans and animals, China. Emerg Infect Dis 2010, 16(8):1195-1203.
• [4]Liu X, Jiang B, Bi P, Yang W, Liu Q: Prevalence of haemorrhagic fever with renal syndrome in mainland China: analysis of National Surveillance Data, 2004–2009. Epidemiol Infect 2012, 140(5):851-857.
• [5]Wang Q, Zhou H, Han YH, Wang XF, Wang SW, Yin WW, Li Q, Xu Z: Epidemiology and surveillance programs on hemorrhagic fever with renal syndrome in Mainland China, 2005–2008. Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi 2010, 31(6):675-680.
• [6]Xiao-fang W, Mao-wu W, Hui S: Epidemiological analysis of hemorrhagic fever with renal syndrome in China from 2004 to 2005. Dis Surveliance 2007, 22(5):307-309.
• [7]Xiaoxia H, Hongmei Y, Lei Y, Xiaofang W, Shiwen W: Epidemiologic characteristics of haemorrhagic fever with renal syndrome in mainland china from 2006 to 2010. West Pac Surveillance Response 2012, 3(1):12-18.
• [8]Hang C, Xie Y, Wang S, Huo Z, Zhang Q: Advances on development of purified bivalent vaccine against Epidemic Hemorrhagic Fever (HFRS) prepared on Vero cells. Bull Med Res 2001, 5:2-4.
• [9]Gong ZY, Weng JQ, Lei JB, Fang CF, Chen EF, Wang Z, Chen ZB, Wang W, He F, Liu BY: Study on a 10-year protective effects of vaccination against hemorrhagic fever with renal syndrome. Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi 2007, 28(12):1190-1193.
• [10]Dahan L: An observation of HFRS bivalent vaccine safety and immunogenicity. Jiangsu J Preventive Med 2008, 4:18-19.
• [11]Yang C, Shiqing L, Si H, Changping C, Renyi Y, Anping Z: A Preliminary observation epidemiological results for HFRS bivalent vaccine. Strait J Preventive Med 2006, 1:28-30.
• [12]Changying C: Effectiveness evaluation and immunization strategies for HFRS bivalent vaccine. Chin J Epidemiol 2003, 2:86-87.
• [13]Luo CW, Chen HX: Epidemiological characteristics and the strategy of vaccination on hemorrhagic fever with renal syndrome in the last 10 years, in China. Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi 2008, 29(10):1017-1019.
• [14]Chang-an M, Zhanzhen W, Zhi-hu Q, Jian-hui Q, Xin T: Analysis of HFRS Epidemiology characteristic after Immunization in Hu- country. Chin J Vector Biol Control 2008, 6:567-569.
• [15]National Pharmacopoeia Committee: Pharmacopoeia of the People's Republic of China, the third division of 2005 edition. Beijing: China Chemical Industry Press; 2005:80-88.
• [16]Ministry of Health of the People’s Republic of China: National Implementing Scheme of Expanded Program on Immunization. 2008. http://www.moh.gov.cn/wsb/s7374/200806/36398.shtml webcite
• [17]Xiong W, Lv J, Li L: A survey of core and support activities of communicable disease surveillance systems at operating-level CDCs in China. BMC Publ Health 2010, 10:704. BioMed Central Full Text
• [18]Wang L, Wang Y, Jin S, Wu Z, Chin DP, Koplan JP, Wilson ME: Emergence and control of infectious diseases in China. Lancet 2008, 372(9649):1598-1605.
• [19]Ministry of Health of the People’s Republic of China: Diagnostic criteria for epidemic hemorrhagic fever (HFRS). 2008. http://www.moh.gov.cn/zwgkzt/s9491/200902/39043.shtml webcite
• [20]Ministry of Health of the People’s Republic of China: Nationwide Surveillance Program for HFRS (try out). 2005. http://www.ivdc.chinacdc.cn/jbkz/jsfa/201110/P020111017505587180289.pdf webcite
• [21]Liu SW, Wang LP, Wang XF, Zhang CX, Guo Q, Zhou MG, MA JQ: Evaluation on management and quality of communicable diseases network direct reporting in China. Dis Surveillance 2009, 2011(5):392-397.
• [22]Wang LJ, Ma JQ, Zhou MG, Wang YY, Ge H, Yang GH: Study on the evaluation of underreporting and the quality of death cases reporting system, from medical institutions at county level and above, in, 2005. Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi 2007, 28(6):571-575.
• [23]Wang LP, Guo Y, Guo Q, ZHANG CX: Evaluation on quality of internet-based reporting of notifiable communicable diseases in China, 2005–2008. Dis Surveillance 2010, 11:912-914.
• [24]Guo HQ, Ding HL, Bo Q, Sun G: Epidemic information of hemorrhagic fever with renal syndrome in China from 2004 to 2009 in ARIMA model. Chin J Zoonoses 2010, 26(12):1137-1140.
• [25]Yan L, Fang LQ, Huang HG, Zhang LQ, Feng D, Zhao WJ, Zhang WY, Li XW, Cao WC: Landscape elements and Hantaan virus-related hemorrhagic fever with renal syndrome, People’s Republic of China. Emerg Infect Dis 2007, 13(9):1301-1306.