2011-2017年宁波市北仑区手足口病流行特征及病原学特征分析

Epidemiological and Pathogenic Characteristics of Hand-foot-mouth Disease in Beilun County in Ningbo City From 2011 to 2017

目的了解2011-2017年宁波市北仑区手足口病的流行特征及病原学特征,为防控手足口病提供参考依据。方法运用描述性流行病学方法、聚类分析方法分析2011-2017年宁波市北仑区手足口病流性特征及病原学检测结果。结果2011-2017年宁波市北仑区累计报告手足口病例15 751例,年平均发病率为363.45/10万,其中重症病例28例,死亡病例2例,发病总体呈上升的趋势。手足口发病高峰主要集中在4-7月,于9-11月出现次高峰。报告病例主要集中在城区及周边地区。发病以5岁以下儿童为主,占发病总数的88.93%,男性HFMD的年均发病率为418.07/10万,女性HFMD的年均发病率为305.21/10万,男女间发病率差异有统计学意义(χ2=368.54,P<0.01),男女性别比为1.50∶1;职业分布以散居儿童(64.68%),幼托儿童(31.72%),学生(3.20%)为主。实验室确诊病例657例,其中EV71型、Cox A16型及其他肠道病毒各占31.96%、30.29%及37.60%。结论宁波市北仑区手足口病疫情的地区性、季节性明显,5岁以下儿童高发,且病原体以其他肠道病毒为主。应继续采取综合防控措施,并强化其他肠道病毒型别的分型及监测,以降低该区手足口病的暴发和流行。

Objective To understand the epidemiological and pathogenic characteristics of hand-foot-mouth disease（ HFMD） in Beilun district of Ningbo city from 2011 to 2017,and provide evidence for the prevention and control of HFMD. Methods Descriptive epidemiological analysis and cluster analysis were conducted on the incidence data and pathogenic data of HFMD in Beilun district during this period. Results A total of 15 751 HFMD cases were reported from 2011 to 2017 in Beilun district,including 28 severe cases and 2 deaths; the average incidence rate was 363. 45/105; and the incidence was on the rise overall. The incidence of HFMD showed obvious seasonality,the incidence peak was mainly during April to July,and a second peak presented in September to November. The cases reported were concentrated in the city and surrounding areas. Most cases involved children aged 1 to 5 years,accounting for 88. 93%. The incidence was 418. 07/105 in males and305. 21/105 in females,the difference was statistically significant（ χ2= 368. 54,P〈0. 01）. The male to female ratio of the cases was 1. 50 to 1. Children in child care settings,children outside child care settings and students were the major populations affected, accounting for 64. 68%, 31. 72% and 3. 20% of the total cases,respectively. A total of 657 HFMD samples were detected,and the positive rates of EV71,Cox A16 and other enteric viral nucleic acid were 31. 96%,30. 29%,37. 60%,respectively. Conclusion HFMD mainly affects children aged 1 to 5 years,the incidence peak is April to July and September to November,and EV71 is the predominant pathogen. Therefore it is necessary to take comprehensive measures to prevent and control the spread and outbreak of HFMD.