EV-71型疫苗接种前后济宁市手足口病发病和病原学变化研究  

Changes in occurrence and etiology of hand-foot-and-mouth disease in Jining City before and after EV-71 vaccination

作　　者：颜丙新[1] 颜丙芳 王体辉 田晓媛[1] 马利君[1] 张国清[4] 骆兰荣 姜文国[3] 孙喜红[3] YAN Bing-xin;YAN Bing-fang;WANG Ti-hui;TIAN Xiao-yuan;MA Li-jun;ZHANG Guo-qing;LUO Lan-rong;JIANG Wen-guo;SUN Xi-hong(Department of Endemic Disease Prevention and Control,Jining Municipal Center for Disease Control and Prevention,Jining 272000,China;Department of Stomatology,Sishui County Hospital of Traditional Chinese Medicine,Sishui 273200,China;Department of Infectious Disease Prevention and Control,Jining Municipal Center for Disease Control and Prevention,Jining 272000,China;Department of Immunization Planning,Jining Municipal Center for Di-sease Control and Prevention,Jining 272000,China)

机构地区：[1]济宁市疾病预防控制中心地方病防制科,山东济宁272000 [2]泗水县中医院口腔科,山东泗水273200 [3]济宁市疾病预防控制中心传染病防制科,山东济宁272000 [4]济宁市疾病预防控制中心免疫规划科,山东济宁272000

出　　处：《中国感染控制杂志》2022年第10期977-983,共7页Chinese Journal of Infection Control

摘　　要：目的了解济宁市2012—2021年肠道病毒71型(EV-71型)疫苗接种前后济宁市手足口病发病和病原学变化情况。方法采用描述性流行病学方法对济宁市手足口病发病和病原学情况进行分析,比较EV-71型疫苗接种前后手足口病发病和病原学变化。结果2012—2021年济宁市6月龄~5岁儿童中,手足口病发病率为658.93/10万,其中,2018年发病率最高(1094.63/10万),2021年发病率最低(247.23/10万)。实验室诊断病例中,EV-71型占27.89%,柯萨奇病毒A16型(CV-A16)占34.59%,非EV-71非CV-A16型占37.52%。6月龄~5岁儿童中,EV-71型估算发病率为131.04/10万,2017年估算发病率最高(322.13/10万),2021年最低(7.71/10万)。重症病例以EV-71型为主,占76.25%。2016—2021年济宁市EV-71疫苗平均估算接种率为7.98%。EV-71型疫苗接种后手足口病EV-71型占比低于接种前,下降4.80%。优势毒株为EV-71型的年份是2013年和2017年,2018年起EV-71型占比开始降低,2021年最低(5.16%)。结论济宁市EV-71型疫苗接种率比较低。接种EV-71型疫苗后,EV-71型估算发病率虽在2017年达到高峰,但之后呈下降趋势,毒株以CV-A16型和非EV-71非CV-A16型居多,应进一步开展非EV-71非CV-A16分型,研发多价手足口病疫苗。Objective To understand the changes in occurrence and etiology of hand-foot-and-mouth disease(HFMD)before and after enterovirus 71(EV-71)vaccination in Jining City from2012 to 2021.Methods Occurrence and etiology of HFMD in Jining City were analyzed by descriptive epidemiological methods.Changes in incidence and pathogens of HFMD before and after EV-71 vaccination were compared.Results From2012 to 2021,incidence of HFMD among children aged 6 months-5 years in Jining City was 658.93/100 000,the highest incidence was 1 094.63/100 000 in 2018,and the lowest incidence was 247.23/100 000 in 2021.In laboratory diagnosis cases,EV-71,coxsackievirus A16(CV-A16),and non-EV-71 non-CV-A16 accounted for 27.89%,34.59%,and37.52%respectively.Among children aged 6 months to 5 years,the estimated incidence of EV-71 was 131.04/100 000,the highest estimated incidence was in2017(322.13/100 000),and the lowest estimated incidence was in2021(7.71/100 000).EV-71 was the main type of severe cases,accounting for 76.25%.The estimated vaccination rate of EV-71 vaccine in Jining City from2016 to 2021 was 7.98% on average.After EV-71 vaccination,the proportion of EV-71 HFMD was lower than that before vaccination,with a decrease of 4.80%.The dominant strain in2013 and 2017 was EV-71,the proportion of EV-71 began to decrease in2018,and the lowest was 5.16%in2021.Conclusion Vaccination rate of EV-71 vaccine in Jining City is relatively low.After inoculation of EV-71 vaccine,the estimated incidence of EV-71 reached the peak in 2017,but then showed a downward trend.The majority of virus strains were CV-A16 and non-EV-71 non-CV-A16,it is necessary to further carry out typing of non-EV-71 non-CV-A16,and develop multivalent HFMD vaccine.

关 键 词：手足口病 EV-71型疫苗 发病数 发病率 病原学 

分 类 号：R181.32[医药卫生—流行病学] R725.1[医药卫生—公共卫生与预防医学]