2010-2018年菏泽市肠道病毒71型感染所致手足口病流行特征分析

Analysis on epidemic characteristics of hand,foot and mouth disease caused by enterovirus 71 infection in Heze City from 2010 to 2018

目的对2010-2018年菏泽市肠道病毒71型(EV71)感染所致手足口病病例的流行病学特征进行分析,为制定手足口病防控措施提供科学依据。方法疫情监测资料来源于2010-01-01-2018-12-31《中国疾病预防控制信息系统》菏泽市手足口病病例资料。病例来源于各县(区)手足口病定点医院。病原学结果来源于菏泽市疾病预防控制中心病毒实验室。人口资料来源于菏泽市统计局年鉴。采用描述性流行病学方法对EV71感染病例资料进行地区、时间、人群分布等特征分析。结果2010-2018年菏泽市共报告手足口病临床诊断病例53214例,平均年发病率为70.15/10万。EV71在临床诊断病例中的感染率为41.02%(1768/4310)。2011年感染率最高为88.17%(343/389),2018年感染率最低为10.38%(57/549),不同年份感染率差异有统计学意义,χ^(2)=1016.386,P<0.001。2011、2013、2015和2017年感染率较高,2012、2014、2016和2018年较低,总体呈隔年感染率较高且有逐渐降低的趋势。EV71感染率最高的是鄄城县为48.61%(228/469),最低的是巨野县为34.82%(148/425),各县区感染率差异有统计学意义,χ^(2)=38.250,P<0.001。流行高发期主要集中于3-5月,占59.16%(1046/1768),男女性别比例为2.05∶1;年龄最小为1个月,最大为16岁,<5岁儿童占98.19%(1736/1768),构成比最高的年龄组依次是1~、2~和3~岁组,分别占37.27%(659/1768)、32.64%(577/1768)和14.25%(252/1768)。涉及聚集性疫情64起,病例187例,其中家庭聚集性疫情25起,占39.06%;自然村聚集性疫情39起,占60.94%。结论2010-2018年菏泽市EV71感染呈隔年强度较高且有逐渐降低的趋势,有明显的时间、人群和地区特征,3-5月是流行高峰期,<5岁特别是1~3岁儿童为重点防治人群。应加强预防控制措施的落实,降低发病率,减少并发症的发生。

Objective To analyze the epidemiological characteristics of hand,foot and mouth disease cases caused by enterovirus 71(EV71)infection in Heze City from 2010 to 2018,so as to provide scientific basis for formulating prevention and control measures of hand,foot and mouth disease.Methods The epidemic situation monitoring data came from the case data of hand,foot and mouth disease in Heze City in China Disease Prevention and Control Information System from 2010-01-01 to 2018-12-31.The cases came from all counties(district)designated hospital for hand,foot and mouth disease.The etiological results came from the virus laboratory of Heze Center for Disease Control and Prevention.The demographic data came from the Yearbook of Heze Bureau of Statistics.The descriptive epidemiological method was used to analyze the characteristics of EV71 infection cases,such as region,time and population distribution.Results Totally 53214 clinically diagnosed cases of hand,foot and mouth disease were reported in Heze City from 2010 to 2018,with an average annual incidence rate of 70.15/10 million.The infection rate of EV71 in clinically diagnosed cases was 41.02%(1768/4310).The highest infection rate in 2011 was 88.17%(343/389),and the lowest infection rate in 2018 was 10.38%(57/549).There was significant difference in infection rates in different years(χ^(2)=1016.386,P<0.001).The infection rate was higher in 2011,2013,2015 and 2017,and lower in 2012,2014,2016 and 2018.Generally,the infection rate was higher every other year and gradually decreased.The highest infection rate of EV71 was 48.61%(228/469)in Juancheng County,and the lowest was 34.82%(148/425)in Juye County.There was significant difference in infection rate among counties(χ^(2)=38.250,P<0.001).The epidemic high incidence period was mainly concentrated in March to May,accounting for 59.16%(1046/1768).The gender ratio of men and women was 2.05∶1,and the youngest was 1 month,the largest was 16years old,and children under 5years old account for 98.19%(1736/1768).The age groups with the highest composition ratio were 1-,2-and 3-years old,accounting for 37.27%(659/1768),32.64%(577/1768)and 14.25%(252/1768),respectively.It involved 64cases of aggregated epidemics,including 187patients.Among them,there were 25cases of family epidemic,accounting for 39.06%,and 39 outbreaks in natural villages,accounting for 60.94%.Conclusions EV71infection in Heze City is higher every other year and gradually decreased from 2010to2018,with obvious time,population and regional characteristics.March to May is the peak of the epidemic.Children under the age of 5,especially children aged 1to 3,are the key prevention and control population.We should strengthen the implementation of prevention and control measures,reduce the incidence rate and complications.