2010-2016年枣庄市手足口病流行病学与病原学特征分析  

Epidemiology and etiology of hand-foot-mouth disease in Zaozhuang,2010-2016

作　　者：张涛[1] ZHANG Tao(Zaozhuang City Center for Disease Control and Prevention,Zaozhuang,Shandong 277101,China)

机构地区：[1]枣庄市疾病预防控制中心,山东枣庄277101

出　　处：《现代预防医学》2018年第19期3475-3479,共5页Modern Preventive Medicine

摘　　要：目的分析枣庄市2010-2016年手足口病流行特征及病原学变化趋势,为制定防控策略提供参考依据。方法采用描述流行病学方法对枣庄市2010-2016年手足口病疫情资料进行分析、荧光定量RT-PCR方法进行肠道病毒核酸检测。结果 2010-2016年累计报告手足口病26 355例,年平均发病率为99. 59/10万。主要集中在4-9月,占总发病数的87. 60%(23 087/26 355)。5岁以下儿童占发病总数的95. 63%(25 202/26 355),散居儿童占病例总数的76. 00%(20 029/26 355)。重症病例188例,0~3岁婴幼儿占90. 43%(170/188)。实验室共检测手足口病1 662例,肠道病毒核酸阳性率62. 76%(1 043/1 662)。2014年前以肠道病毒71型(EV71)和柯萨奇病毒A组16型(Cox A16)为主,2015年后其他肠道病毒成为优势病原体;优势病原体变换时间在4月份。重症病例中EV71构成比为87. 72%(100/114)高于普通病例45. 10%(419/929)。结论手足口病发病具有明显的季节、年龄、性别和职业特征。优势病原体呈现出变换的特点,提示应进一步加强疫情和病原学监测,分析病原体变化规律和病毒变异情况,落实综合性防控措施。Objective To analyze epidemiological and etiological characteristics of hand, foot and mouth disease （HFMD） in Zaozhuang City, Shandong Province from 2010 to 2016, and to provide a reference for the development of prevention and control strategies. Methods Descriptive epidemiological methods were used to analyze the laboratory data within the city were collected among 2010 -2016, of which throat - swab or anal - swab specimens came from HFMD designated hospital, and the virus nucleic acid was detected by real - time fluorescence RT - PCR method. Results A total of 26 355 HFMD cases were reported from 2010 to 2016, and the average annual incidence rate was 99. 59 per 100 thousand populations. Seasonal distribution was clear for HFMD in Zaozhuang City, when the epidemic period began from April to September. And the number of cases proportion to the annual total incidence was 87.60% （23 087/26 355）. The majority （95.63%, 25 202/26 355） of the cases occurred among children under five years old, and scattered children accounted for 76.00% （20 029/26 355 ）. 188 severe cases were reported, and the majority of the severe cases mainly occurred among children under three years old （90. 43%, 170/188）. A total of 1662 cases of hand, foot and mouth disease were detected in the laboratory, and the positive rate of enterovirus nucleic acid was 62.76% （1 043/1 662）. Predominant strain during 2010 -2014 was human enterovirus 71 （EV71） and coxsackievirus A 16 （CA16） ; while non- EV71 and non- CA16 enterovirus （other EV）, was the predominant strain during 2015 -2016, and the predominant pathogens of HFMD switched in April. EVTI infection positive ration in severe HFMD cases was 87.72% （ 100/114）, which was higher than that in mild cases （45.10%, 419/929）. And there was a high correlation between severe cases and EV71 （E2= 73.77, P 〈 0.01 ）. Conclusion The epidemiologic characteristics of HFMD had a close relationship with season age, gender and occupation. As the types of predominan

关 键 词：手足口病 流行病学 病原学 重症病例 

分 类 号：R181.23[医药卫生—流行病学]