2008-2009年中国大陆手足口病流行特征分析

Epidemiology of hand foot and mouth disease in mainland of China,2008-2009

目的分析2008-2009年我国大陆地区手足口病流行病学特征,为手足口病的科学防控提供依据。方法根据《疾病监测信息报告管理系统》2008-2009年全国报告手足口病个案信息进行分析。结果 2008-2009年我国大陆地区共报告手足口病发病1 644 480例,重症14 977例,死亡479人。随着时间的推移,疫情空间分布由中部地区逐步向东部、南部和北部地区推移,且2008年疫情较重的地区,2009年报告病例数有所减少。发病人群主要为<5岁婴幼儿,占报告发病总数的93.86%,其中<3岁婴幼儿占79.69%,1～2岁组患儿患病后发生重症和死亡风险高于其他年龄组。实验室诊断病例共报告30 953例,其中肠道病毒71型(EV71)阳性占50.81%,柯萨奇病毒A16型(Cox A16)阳性占28.27%,其他肠道病毒阳性占20.93%。结论近2年我国大陆地区手足口病的高发病率和由EV71感染引起的重症和死亡病例大幅度上升,所造成的疾病负担不容忽视,目前已成为重要的公共卫生问题。针对EV71占绝对优势的局部地区,应早期采取相关干预措施,加强重症病例的救治,降低死亡率。同时应针对手足口病防控工作中尚未解决的技术问题开展专项研究。

Objective To analyze the epidemiological characteristics of hand foot and mouth disease （HFMD） in the mainland of China during 2008-2009. Methods The analysis was conducted on the incidence data of HFMD during 2008-2009 collected from the national disease reporting information system. Results A total of 1 664 480 cases of HFMD, including 14 977 severe cases and 479 deaths, were reported during this period. As time goes on, the disease spread gradually from central area to eastern, southern and northern areas. The reported case numbers declined in 2009 in the areas with high case numbers in 2008. Most cases were children aged 〈 5 years, accounting for 93.86% of the total. Among these cases, those in children age 〈 3 years accounted for 79.69%. The risks to become severe case or of death were greater in age group of 1 -2 than in other groups. Totally 30 953 cases were laboratory confirmed, of which EV71 infections, Cox A16 infections and other enteric virus infections accounted for 50. 81%, 28.27% and 20.93% respectively. Conclusion In recent 2 years, the incidence of HFMD and the incidences of severe cases and deaths caused by EV71 infection increased substantially in the mainland of China. , which resulted in serious disease burden and public health problem. In the areas where EV71 is predominant, it is necessary to take effective intervention measures in early phase and strengthen the medical treatment of severe cases to reduce the case fatality. Further study should be conducted on the technical problems still existed in the prevention and control of HFMD.