2009年聊城市手足口病流行病学特征分析

Analysis on Epidemiological Features of Hand-foot-mouth Disease,Liaocheng City,2009

[目的]分析2009年聊城市手足口病流行病学特征，研究聊城市手足口病重症患儿发病高危因素，为控制手足口病、最大限度降低重症发生率提供科学依据。[方法]收集整理聊城市2009年各级各类医疗机构报告的手足口病报告卡信息及2009年RT-PCR实验室检测结果，对50例重症患者开展流行病学调查。[结果]2009年聊城市手足口病报告发病率277．60／10万，重症641例，重症发生率4％，死亡3例，病死率为0．02％。全市8个县区均有手足口病病例报告。县区之间报告发病率差异有统计学意义（P〈0．01）。4～9月为报告发病高峰。病例年龄分布以小年龄组为主，5岁以下儿童报告发病15504例，占总病例数的96．8％，1岁组患儿重症发生率最高，占总重症数的47．27％。共检测65份样本，EV71阳性率为12．3％、CoxA165．9％；在基层接受治疗、多次转诊是重症发生的重要原因。[结论]聊城市手足口病防控形势严峻，对5岁以下年龄组人群应加强手足口病监测工作。对重症发生率高的地区临床医护人员进行救治能力的强化培训及严格落实禁止基层医疗机构接诊发热皮疹患者的相关规定，实施以开展爱国卫生运动、强化健康教育宣传、落实群防群控等为主的综合防控措施经证明是富有成效的。但这种“严防死守”的防治措施在短期内虽效果显著，但很难坚持，应建立一种传染病防控宣传教育及临床救治的长效机制，防患于未然。

[Objective]To analyze the epidemiological features of hand-foot-mouth disease （HFMD） in Liaocheng city in 2009, study the high risk factors for occurrence of severe cases,and provide scientific basis for the control and reduction of severe cases. [Methods]Data were collected on information of hand-foot-mouth disease report cards and results of RT-PCR tests in Liaocheng city in 2009, and an epidemiological investigation was made on 50 severe cases. [Results]The incidence of hand-foot-month disease was 277.60/10^5 in Liaocheng in 2009, with 641 severe cases,the incidence at 4%, 3 died and the case-fatality rate was 0.02 %. The cases were reported in 8 counties and districts. There were significant differences in the HFMD incidence among the counties and districts （ P 〈0.01）. The peak of hand-foot-mouth disease was from April to September. The age distribution was mainly in the younger age groups, 15 504 cases were reported in the age groups under 5 ,accounting for 96.8% of the total. The highest incidence of severe cases was in the age group at 1, accounting for 4 7.27 % of the total. A total of 65 specimens were detected. The positive rate of EV71 and Cox A16 was 12.3 % and 5.9 % .The main causes for the incidence of severe cases were treatment at grassroots and multiple referrals. [Conclusion]The prevalence of HFMD is serious in Liaocheng. Surveillance should be strengthened in the age groups under 5. Intensive training should be conducted on clinical staff in the areas with high incidence of severe cases in the abilities of rescue and treatment,and strict implementation of the relevant provisions in prohibiting primary clinical institutions admissions from treating heat rash patients. Implementation of launching the patriotic public health campaign, strengthening health education and publicity, and collective prevention and control-based, integrated prevention and control measures are proved to be fruitful. These strict prevention and control measures are significantly effective in the short term, but difficult to adhere to, a long-term mechanism for infectious disease prevention and control should he established to promote education and clinical treatment, and preventive measures should be taken in advance.