2017-2018年惠州市手足口病流行病学调查及病原学分析

Epidemiological Survey and Pathogenic Analysis of Hand, Foot and Mouth Disease in Huizhou City from 2017 to 2018

目的:探究2017至2018年惠州市手足口病(HFMD)流行病学调查及病原学特征。方法:选取2017年1月至2018年12月惠州市200例HFMD患儿作为研究对象,统计患儿临床资料,入选病例均进行肠道病毒通用型(CHEV)、肠道病毒71(EV71)型、柯萨奇病毒A组(CoxA)16型核酸检测,分析手足口病流行病学及病原学特征。结果:200例HFMD患儿中,年龄最大10岁,最小32 d,患儿年龄主要集中在1~4岁,共有157例,占比78.50%;其次是4~6岁患儿,共有29例,占比14.5%。男性患儿122例,女性患儿78例,男女发病比例为1.56∶1;2017至2018年报告发病数基本维持平衡,四季均有分布,从4月份发病率开始升高,2017年7月份达到高峰,2018年6月份达到高峰,8月后发病率开始降低,10~12月份略有升高;5个县区中,200例HFMD患儿分布率由高到低依次为惠东县(32.50%)>龙门县(28.50%)>博罗县(15.00%)>惠阳区(13.50%)>惠城区(10.50%);病例类型主要轻症病例,占比89.50%;肠道病毒核酸检测结果显示:主要为EV71感染,共174例,占比87.00%,CoxA16感染者21例,占比10.50%,其他肠道病毒感染者5例,占比2.50%;200例HFMD患儿中,168例患儿接种EV71疫苗,占比84.00%,均为轻症患儿,其他32例未接种患儿中21例重症患儿。结论:2017至2018年惠州市HFMD患儿主要为1~5岁患儿,男性明显多于女性,每年高发时间段为4~7月,主城区发病患儿较少,主要感染类型为EV71,接种EV71疫苗者可有效预防EV71感染的重症HFMD,有助于减轻患儿病情,应继续做好EV71疫苗接种工作。

Objective:To investigate the epidemiological investigation and etiological characteristics of hand,foot and mouth disease(HFMD)in Huizhou City from 2017 to 2018.Method:200 children with HFMD in Huizhou City from January 2017 to December 2018 were selected as the research objects.The clinical data of the children were analyzed.The selected cases were detected for enterovirus general type(CHEV),enterovirus 71(EV71),coxsackievirus A group(CoxA)16 nucleic acid,and the epidemiological and etiological characteristics of the disease were analyzed.Results:Among the 200 children with HFMD,the age was 10 years old and the youngest was 32 days.The age of the children was mainly 1 to 4 years old,a total of 157 cases,accounting for 78.50%;followed by children aged 4 to 6 years,a total of 29 cases,accounting for More than 14.5%.There were 122 males and 78 females,and the ratio of male to female was 1.56:1.The number of reported cases was basically balanced from 2017 to 2018,and the four seasons were distributed.The incidence rate increased from April to July 2017.The peak reached its peak in June 2018.After August,the incidence rate began to decrease,and it increased slightly from October to December.Among the five counties,the distribution rate of 200 children with HFMD from high to low was Huidong County(32.50).%)>Longmen County(28.50%)>Bolo County(15.00%)>Huiyang District(13.50%)>Huicheng District(10.50%);The main mild cases of case types accounted for 89.50%;the results of enterovirus nucleic acid test showed that 174 cases were mainly EV71 infection,accounting for 87.00%,and 21 cases of CoxA16 infection,accounting for 10.50%,other enterovirus infections.In 5 cases,accounting for 2.50%;of the 200 children with HFMD,168 children were vaccinated with EV71,accounting for84.00%,all of whom were mild children,and 21 of the 32 children who were not vaccinated were severely ill.Conclusions:From 2017 to 2018,the children with HFMD in Huizhou City were mainly children aged 1 to 5 years old.The number of males was significantly higher than that of females.The annual high incidence period was from April to July.There were fewer children in the main city.The main infection type was EV71.Vaccines can effectively prevent severe HFMD infection in EV71,help to reduce the condition of children,and should continue to do EV71 vaccination.