目的掌握浙江省肾综合征出血热(HFRS)人间和动物间疫情动态变化,为制定防制对策提供依据。方法选择监测点分析人间疫情,开展宿主动物调查,测定鼠密度和带病毒率,采集病人血清进行分型鉴定。结果1984～2001年天台县、开化县、江山市、宁海县及金华婺城区5个监测点共发生HFRS病人12027例,死亡86例,年平均发病率为35.52/10万,死亡率为0.25/10万,病死率为0.72%。以20世纪80年代发病较高,1986年达到高峰,发病率达119.84/10万。开化县发病率最高,年平均79.03/10万。每年11月至次年1月为流行高峰,占病例总数的44.55%(5334/11974),4～6月为流行小高峰,占20.57%(2463/11974),季节分布呈双峰型。年龄分布以青壮年为主,其中26～45岁人群发病4818例,占病例总数(9715例)的49.59%;男女之比为1.71∶1;农民占发病总数的86.25%。室内、外平均鼠密度为9.98%(34411/344741)。其中室外鼠密度为10.84%(19839/183003),居民区为9.01%(14572/161738)。开化县鼠密度最高,达到14.47%(4521/31249)。室内以褐家鼠为优势鼠种,占75.87%,其次为小家鼠;野外以黑线姬鼠为优势鼠种,占74.44%,其次为黄毛鼠。黑线姬鼠带病毒率为5.21%(598/11477),褐家鼠带病毒率为4.18%(375/8979)。临床确诊病人的血清阳性率为67.81%(4008/5911),恢复期血清分型鉴定,姬鼠(Ⅰ)型病人占60.91%(296/486),家鼠(Ⅱ)型病人占32.51%(158/486),另有6.58%(32/486)的病人未分型。健康人群隐性感染率为3.58%。结论浙江省属以姬鼠型为主的混合型HFRS疫区,鼠密度和带病毒率仍然较高,需要加强监测和防制。 Objective To understand the dynamic changes of epidemic situation in humans and animals with HFRS in Zhejiang Province, and to provide evidence for the development of control strategies. Methods The monitoring points were selected to analyze the human epidemic situation, investigate the host animals, determine the rat density and virus-carrying rate, and collect the patient’s serum for typing. Results From 1984 to 2001, 12027 HFRS patients and 86 deaths were found in 5 monitoring sites of Tiantai, Kaihua, Jiangshan, Ninghai and Jinhua in Wucheng, 1984 with an average annual incidence of 35.52 / lakh and a mortality rate of 0.25 / 100,000, fatality rate was 0.72%. In the 1980s a higher incidence of disease, peaked in 1986, the incidence rate of 119.84 / 100000. The highest incidence of Kaihua County, the average annual 79.03 / 100,000. From November to January of each year, it is the epidemic peak, accounting for 44.55% (5334/11974) of the total number of cases. It is a small epidemic peak from April to June, accounting for 20.57% (2463/11974). The seasonal distribution is bimodal. The distribution of age was mainly young and middle aged, of which 4818 were from 26 to 45 years old, accounting for 49.59% of the total number of cases (9715 cases). The ratio of male to female was 1.71:1. Farmers accounted for 86.25% of the total cases. The average indoor and outside rat density was 9.98% (34411/344741). The outdoor rat density was 10.84% ​​(19839/183003), residential area was 9.01% (14572/161738). Kaihua County, the highest density of rats, reaching 14.47% (4521/31249). Rattus norvegicus was the dominant species indoors, accounting for 75.87%, followed by Mus musculus; Apodemus agrarius was the dominant species in the wild, accounting for 74.44%, followed by Rattus rat. Apodemus agrarius virus rate was 5.21% (598/11477), Rattus norvegicus virus rate was 4.18% (375/8979). The seroprevalence of clinically diagnosed patients was 67.81% (4008/5911). Serum type was identified during convalescent phase. The percentage of Apodemus patients (Ⅰ) was 60.91% (296/486) and that of domestic mice (Ⅱ) was 32.51% (Ⅱ) 158/486), while another 6.58% (32/486) of patients were not typed. The prevalence of latent infection in healthy population was 3.58%. Conclusions Zhejiang Province belongs to the mixed type HFRS epidemic area which is mainly composed of Apodemus species. The rat density and virus carrying rate are still high, so it needs to be strengthened to monitor and control.