江苏省2008至2010年手足口病流行病学及病原学特征分析  

Epidemiology and etiology of hand-foot-and-mouth disease seen in Jiangsu province from 2008 to 2010

作　　者：嵇红[1] 李亮[1] 吴斌[1] 许可[1] 霍翔[1] 单军[1] 刘文东[1] 张伟伟[2] 汤奋扬[1] 朱凤才[1] 祖荣强[1] 

机构地区：[1]江苏省疾病预防控制中心急性传染病防制所,南京210009 [2]东南大学公共卫生学院流行病与卫生统计专业

出　　处：《中华儿科杂志》2012年第4期261-266,共6页Chinese Journal of Pediatrics

摘　　要：目的分析江苏省2008至2010年手足口病的流行病学和病原学特征，为手足口病的防治提供科学依据。方法利用国家疾病监测信息管理系统开展手足口病监测，采用描述性流行病学方法对江苏省2008至2010年手足口病监测资料和部分患者病原学监测结果进行统计和分析，采用荧光定量RT—PCR方法对部分手足口病例进行肠道病毒（enterovirus，EV）核酸检测。结果江苏省2008至2010年手足口病平均发病率为86．70／10万，发病高峰集中在4至7月份；苏南地区的发病率高于苏中地区，苏中地区发病率高于苏北地区，且差异有统计学意义，例如，2010年的发病率苏南为188．990／10万，苏中为109．040／10万，苏北为55．155／10万；以5岁以下的散居儿童或幼托儿童为主，男性发病高于女性（男：女2008年为1．76：1，2009年为1．67：1，2010年为1．64：1），普通病例以肠道病毒71型（EV71）和柯萨奇病毒A16型（CoxA16）共同主导流行，重症病例和死亡病例以EV71为流行优势株。结论江苏省手足口病流行具有明显的季节性、人群性以及地区性，引起手足口病普通病例流行的病原体主要为EV7l和CoxA16，且不同年份间流行优势株有所差别，重症病例和死亡病例的流行优势毒株均为EV71。Objective To analyze the etiological and epidemiological characteristics of hand-foot- and-mouth disease （HFMD）seen in Jiangsu province from 2008 to 2010, and provide evidence for its prevention and control. Methods Based on the requirement of supervision program of HFMD, surveillance and report were done according to National Disease Supervision Information Management System. Descriptive epidemiological method, performed between 2008 and 2010, was used to analyze the time, region and population distribution and results of etiologic analysis of HFMD. Nucleic acid of enterovirus （EV） genome was detected by real-time RT-PCR. Results The average incidence rate of HFMD was 86.70 per million between 2008 and 2010, the peak incidence occurred in April to July. There were significant differences among the incidence in different districts （ P 〈 0. 05 ） , and the highest incidence was seen in the densely inhabited southern areas of Jiangsu province. Most of the cases were infants and children aged less than 5 years. The number of male cases （2008：17 008,2009：48 768,2010：50 231 ）was much larger than that of the female cases 2008：9662,2009：29 151,2010：30 655. The HFMD cases with mild symptoms were caused mainly by enterovirus 71 （ EV71 ） and coxsackievirus A16 （ Cox A16） and there was difference among different years. The severe HFMD cases and deaths were mainly caused by EV71 infection. Conclusions The epidemiologic characteristics of HFMD in Jiangsu province from 2008 to 2010 had close relationship with season, population and region. The mild cases of HFMD were mainly infected with EV71 and Cox A16. However, EV71 illness seemed to be more severe and had significantly greater frequency of serious complications and fatality than the illness caused by Cox A16.

关 键 词：手足口病 流行病学 人群监测 肠道病毒71型 柯萨奇病毒A16型 

分 类 号：R725.1[医药卫生—儿科]