渭河流域城市化对HFRS高位流行的驱动效应研究

Hemorrhagic fever with renal syndrome (HFRS) is a rodent-borne natural focus disease that seriously threaten public health. Weihe River Basin in the northwestern China belongs to traditionally severe HFRS foci, especially the epidemic in 2017 reached the highest in the past decade. The occurrence of HFRS infections was affected significantly by the habitats of rodents , human activities, particularly rapid urbanization construction destroyed the original habitats and activity rhythm of mice, which increased the exposure risk of population. Recently, HFRS continued high prevalence in the Weihe River Basin, meanwhile, some new epidemic trends appeared, which high incidence areas spread to surroundings of city and the disease outbreak occasionally. The signs suggest HFRS epidemic is closely related to the construction of urban, but the influence of urbanization on HFRS has not got enough attention. Therefore, this research will carry out the study on the driving effect of urbanization on the HFRS in the Weihe River Basin. Through integrating the information of environmental dynamic indicators, animal host surveys and surveillance data of HFRS in the process of urbanization in the past 20 years, we assessed the key influencing factors and driving effects of urbanization on the disease. Then, the relationships between the change of host animal community and the fluctuation of HFRS incidence at different levels of urbanization were evaluated through the field investigation, and a time-space dynamic simulation modelwas established. Our study would assist health officials in developing and targeting HFRS interventions, and also provide reference for similar diseases in urbanization.

肾综合征出血热（HFRS）是严重威胁人类健康的鼠源自然疫源性疾病。我国西北的渭河流域一直是HFRS高发疫源地，2017年病例数更是近10年高峰。人间HFRS疫情与宿主栖息环境息息相关，人类生产活动尤其是快速城市化建设破坏了宿主原有的栖息地和活动规律，增加了人群暴露风险。近年来，渭河流域HFRS持续高位流行，且出现高发疫点、疫区向城市周边蔓延，暴发疫情增多等态势。种种迹象表明HFRS疫情与城市化建设密切关联，但城市化对HFRS的影响作用却没有得到足够关注。本课题拟开展渭河流域城市化对HFRS高位流行的驱动效应研究，首先整合近20年城市化环境动态指标、动物宿主调查、人群监测等信息，评估城市化对HFRS流行的关键影响因素和驱动模式；再通过现场调查分析城市化环境突变对宿主群落与人间疫情的影响规律，构建城市化HFRS流行时空动态模型，为HFRS防控提供依据，也为城市化中类似疾病研究提供参考。

肾综合征出血热（HFRS）是严重威胁人类健康的鼠传自然疫源性疾病，近年来，渭河流域HFRS持续高位流行，且出现了高发疫点、疫区向城市周边蔓延，暴发疫情增多等态势，种种迹象表明快速城市化进程中地表环境的突变影响了鼠的栖息环境和活动规律，因此阐明城市化影响HFRS流行的关键因素和驱动模式对疾病防控具有迫切现实意义。本课题通过现场调查监测获取鼠类信息、人间疫情等，同时基于遥感影像提取的城市化环境动态指标，进行量化研究。HFRS时空动态模型结果发现快速城市化进程中环境变化对区域HFRS发病率的影响存在6年的时间临界值，0-6年城市化区域发病率升高，6年以后城市化区域的发病率快速降低；与城市化进程中HFRS对非农民职业群体的影响程度更大。水体分布对HFRS发病率的影响表现为距离水体越近发病率越高，同时存在696.15 m和1575.39 m两个特征阈值。空地理加权回归模型（GTWR）结果表明陕西省HFRS 地理分布主要受自然气候和人类活动两大类因素影响，其中自然环境和气候的作用相对稳定，而人类经济活动的影响作用近年来显著上升，这种作用在渭河流域体现尤为明显。宿主动物调查结果显示：西安市及周边地区鼠类以姬鼠属为主，家鼠属次之，黑线姬鼠所占比例最高，为优势物种，其次为褐家鼠和小家鼠，随着城市化侵占农田、草地区域，野外黑线姬鼠种群栖息环境遭到破坏，长安区、鄠邑区等部分新建城区出现了姬鼠踪迹，增加了人群患病风险。基于现代空间信息技术开发的HFRS可视化系统（环境-动物-人），有效增强了疾病防控部门对HFRS多源数据管理存储和可视化分析能力。上述项目研究结果提示卫生决策部门应该重视城市化建设中自然环境、社会环境和人类活动改变对HFRS的影响作用，制定针对性防控措施，防止疾病的暴发流行。