2009-2019年平顶山市手足口病流行特征分析  

Epidemiological characteristics of hand-foot-mouth disease from 2009 to 2019 in Pingdingshan City

作　　者：李艳艳[1] 李宗瑾[1] 宋秋坤[1] 王轶[1] 刘娜 王慧晶[1] 张俊杰[1] 马西平[1] LI Yan-yan;LI Zong-jin;SONG Qiu-kun;WANG Yi;LIU Na;WANG Hui-jing;ZHANG Jun-jie;MA Xi-ping(Department of Communicable Disease Control and Prevention of Pingdingshan Center for Disease Control and Prevention,Pingdingshan 467099,Henan Province,China)

机构地区：[1]平顶山市疾病预防控制中心传控科,河南平顶山467099

出　　处：《微生物学免疫学进展》2021年第3期47-52,共6页Progress In Microbiology and Immunology

摘　　要：目的分析2009—2019年平顶山市手足口病(hand-foot-mouth disease,HFMD)流行特征,为今后本地制定防控措施提供依据。方法对中国疾病预防控制信息系统报告的平顶山市2009-2019年HFMD病例信息进行描述性流行病学分析。结果2009—2019年平顶山市共有HFMD报告病例53477例,重症病例5878例,死亡16例,年均发病率为109.70/10万,重症比例为10.99%,年均死亡率为0.03/10万。2010年和2014年出现了2次HFMD大规模流行。城市市区发病率明显高于郊县。报告病例时间分布呈现明显的春,夏季节性高发,呈单峰分布,4—5月出现高峰。人群分布情况,男性明显多于女性;报告病例集中在0~5岁组儿童,有50557例,占94.54%;人群散居儿童报告病例较多,有40352例,占75.46%。病原学特征以肠道病毒71型(Enterovirus71,EV71)阳性为主,HFMD病原谱有一定变化,EV71阳性构成比自2015年以来逐渐降低,EV71构成比的变化与重症比例呈正比例变化,两者呈正相关(r=0.876),差异有统计学意义(P<0.05)。全市聚集性疫情的发生与HFMD疫情的整体趋势一致,而幼托机构是聚集性发生的主要场所。接种肠道病毒71型灭活疫苗(简称EV71疫苗)的HFMD病例中无EV71阳性病例,接种EV71疫苗和未接种疫苗病例的EV71阳性检出率差异无统计学意义(X^(2)=2.517,P=0.113,P>0.05)。结论在HFMD流行季节,须加强5岁以下儿童及托幼机构等场所的防控工作,减少聚集性疫情的发生,推广EV71疫苗接种是控制HFMD疫情的关键。Objective To analyze the epidemiological characteristics of Hand-foot-mouth disease(HFMD) in Pingdingshan City from 2009 to 2019, and to provide a scientific basis in prevention and control of the disease. Methods Descriptive epidemiological method was used to analyze the data from routine report system for infectious disease from 2009 to 2019. Results A total of 16 deaths and 5 878 cases of severe in 53 477 HFMD cases were reported in this period, with a high incidence occurred in 2010 and 2014. The annual average incidence was 109.70 per 100 000, the ratio of severe case was 10.99 %, and the average annual mortality was 0.03 per 100 000. The incidence in urban area was higher than that in suburb area. The epidemic peak appeared from April to May. The male cases of HFMD were more than female cases, and the children younger than 5 years old were the maximum(50 557 cases, 94.54%). The most cases of occupation were scattered children(40 352 cases, 75.46%). The major type of HFMD clustering was kindergarten clustering. Since 2015, the composition ratio of human enterovirus 71(EV71), the main pathogen in HFMD, dropped obviously. There was a positive correlation between the ratio of severe cases and the composition ratio of EV71(r=0.876, P<0.05). No EV71 positive cases were detected in HFMD patients who had received inactivated EV71 vaccine, and the positive rate of EV71 between vaccinated and unvaccinated patients was not statistically significant(χ^(2)=2.517, P=0.113, P>0.05). Conclusion Intervention and prevention measures should be focus predominantly on children younger than 5 years old and kindergartens during April to May to reduce the incidence of HFMD.

关 键 词：手足口病 流行特征 肠道病毒71型 柯萨奇病毒A16型 分析 

分 类 号：R512.5[医药卫生—内科学]