2012–2020年成都市手足口病流行病学特征及EV71疫苗接种效果分析  

Epidemiological Characteristics of Hand,Foot,and Mouth Disease and the Effect of EV71 Vaccination in Chengdu from 2012 to 2020

作　　者：唐雪琴 张量智[2] 孟建彤[3] 陈恒[3] 程悦 袁萍[1] 龙璐 TANG Xue-qin;ZHANG Liang-zhi;MENG Jian-tong;CHEN Heng;CHENG Yue;YUAN Ping;LONG Lu(Department of Epidemiology and Health Statistics,West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu 610041,China;Department of Immunization Planning,Chengdu Municipal Center for Disease Control and Prevention,Chengdu 610041,China;Department of Microbiology Laboratory,Chengdu Municipal Center for Disease Control and Prevention,Chengdu 610041,China)

机构地区：[1]四川大学华西公共卫生学院/四川大学华西第四医院流行病与卫生统计学系,成都610041 [2]成都市疾病预防控制中心免疫规划科,成都610041 [3]成都市疾病预防控制中心微生物检验科,成都610041

出　　处：《四川大学学报（医学版）》2022年第6期1074-1080,共7页Journal of Sichuan University(Medical Sciences)

基　　金：国家自然科学基金青年科学基金(No.81903375);中国博士后科学基金面上项目(No.188309);成都市科技局技术创新研发项目(No.2019-YF05-01080-SN)资助。

摘　　要：目的分析2012–2020年成都市的手足口病流行病学特征,比较成都市在疫苗接种前后的发病差异,为手足口病的预防提供依据。方法采用描述性流行病学分析方法,对成都市2012–2020年报告的手足口病病例的发病率、病死率、重症率等进行分析。结果2012–2020年成都市手足口病累计发病279216例,重症2201例,死亡16例。2012–2019年发病率隔年上升,2018年达最大发病率(326.43/105);重症率和病死率自2016年以来,呈现下降趋势。共有实验室检测病例11892例,EV71、Cox A16和其他肠道病毒分别占总数的14.8%、18.8%、66.3%。自2016年EV71型病毒感染发病总体呈下降趋势,Cox A16病毒型感染隔年上升,其他肠道病毒型感染总体呈上升趋势。病例主要集中在0~<5岁儿童组(92.1%),尤以1~<2岁组发病最多,各年份均表现为男性发病高于女性。地区分布表明手足口病的高发地区在中心城市,平局发病率增速最大的三个区分别为:青白江区、双流区、龙泉驿区。时间分布表明手足口病发病呈明显的双峰分布,大部分集中在每年5–8月和10–12月,2018年7月发病达历年最高(12309例)。结论成都市未来在继续推进EV71疫苗接种的同时,更需要关注除EV71和Cox A16外的血清型病毒感染,开展针对多种肠道病毒的多价疫苗的相关研究。防控重点可放在人口密度大、流动人口多、涉农街道多以及人员卫生意识不够强的地区。针对第二圈层的城区,可以加强对涉农街道的消毒,同时对卫生意识不强的人员和托幼机构进行卫生宣讲等活动。另外手足口病防控也可在高发季节给予更多关注。Objective To analyze the epidemiological characteristics of hand,foot,and mouth disease(HFMD)in Chengdu from 2012 to 2020,to make comparison in order to examine the changes in incidence before and after vaccination was introduced,and to provide basis for the prevention of HFMD in the future.Methods Descriptive epidemiological methods were adopted to analyze the incidence,mortality and rate of severe cases of HFMD cases reported in Chengdu from 2012 to 2020.Results From 2012 to 2020,the cumulative cases of HFMD reported in Chengdu were as many as 279216,of which,there were 2201 severe cases and 16 deaths.The incidence increased every other year,reaching 326.43 per 100000 person-years,the highest ever,in 2018.The rate of severe cases and mortality had shown a decreasing trend since 2016.A total of 11892 cases of EV71,CoxA16 and other enteroviruses were detected in the laboratory,accounting for 14.8%,18.8%and 66.3%,respectively.Since 2016,HFMD cases caused by EV71 virus infection had shown an overall decreasing trend,cases caused by Cox A16 virus infection had increased every other year,and cases caused by other enteroviral infections had shown an overall increasing trend.The reported cases were mainly concentrated in children aged 0-5 years(92.1%),with those in the age group of 1-2 years reporting the highest number of cases.For children of different ages,male patients always outnumber female patients.The geographic distribution showed that the areas with high HFMD incidence were always located in the central part of Chengdu City,and the three districts with the highest incidence growth rate were Qingbaijiang District,Shuangliu District,and Longquanyi District.Temporal distribution of HFMD cases showed an obvious bimodal distribution,with most of the cases concentrated in May through August and October through December of each year.The number of new cases reached the highest(12309 cases)in July 2018.Conclusion While continuing to promote EV71 vaccination in the future,Chengdu also needs to pay more attention to vir

关 键 词：手足口病 发病率 成都市 接种 流行病学 

分 类 号：R181.3[医药卫生—流行病学] R725.1[医药卫生—公共卫生与预防医学]