2009-2017年北京市海淀区手足口病流行病学及病原学特征分析

Epidemiological and Etiological Characteristics Analysis of Hand-foot-mouth Disease in Haidian District of Beijing From 2009 to 2017

目的分析2009-2017年北京市海淀区手足口病流行特征,为制定预防控制措施提供科学依据。方法采用描述流行病学方法,病例信息来源于"中国疾病预防控制信息系统",对2009-2017年手足口病病例信息进行分析,在海淀区1家哨点监测医院,2009-2017年每月采集5例临床诊断为手足口病病例咽拭子标本,用实时荧光定量PCR方法对肠道病毒进行检测。结果海淀区2009-2017年共报告手足口病病例36 649例,年报告发病率范围为71.31/10万~231.07/10万,呈现大小年交替流行趋势。3岁组发病率最高,为4 040.99/10万。散居儿童和幼托儿童报告病例数最多,占全部病例数的92.04%。主要以夏季发病为主,每年5-7月报告病例数最多,流动人口较多地区发病率较高。重症病例233例,死亡3例,重症病死率1.29%。不同年份CoxA16、EV71和其他肠道病毒构成比差异有统计学意义(χ~2=183.526,P<0.01)。结论北京市海淀区2009-2017年手足口病流行病学特征显示散居儿童和幼托儿童为高发人群,夏季是高发季节。非CoxA16、EV71的肠道病毒应给予重点关注,重症早期识别及时救治对挽救生命具有重要意义。

Objective By analysising the hand-foot-mouth disease(HFMD) epidemic characteristics of Beijing Haidian district from 2009 to 2017, to provide scientific basis for disease prevention and control measures. Methods Using the description epidemiology method to analysis the information of HFMD with the case information from China Information System for Disease Control and Prevention from 2009 to 2017. From 2009 to 2017, pharyngeal swabs of 5 cases clinically diagnosed as hand-foot-mouth disease were collected every month in a sentinel-monitoring hospital in Haidian district, Real-time fluorescence quantitative PCR was used to detect the enterovirus.Results A total of 36 649 HFMD cases were reported in Haidian district from 2009 to 2017, the annual report incidence was about 71.31/105 to231.07/105, showing a trend of alternating popularity in large and small years. The highest incidence was in the age group of 3 to 4 years old, with an incidence rate of 4 040.99/105. The number of reported cases was the highest among children in the diaspora and early childhood care,accounting for 92.04% of all cases. Most of the cases were reported in summer,from May to July each year,the incidence rate of floating population was higher than other population. There were 233 cases of severe disease, 3 cases of death,the severe case fatality rate was 1.29%. There were significant differences of the composition ratios between CoxA16, EV71 and other enterovirus in different years(χ~2=183.526,P<0.01).Conclusion Epidemiological characteristics of HFMD in Haidian district of Beijing from 2009 to2017 shows that children living in the diaspora and children in early care are high incidence population,and summer is a high incidence season. The non-CoxA16,EV71 enterovirus should be paid more attention. It is very important to save lives in the early stage of severe disease.