重庆市2010年手足口病流行病学特征

Epidemiological analysis of hand-foot-mouth disease in Chongqing in 2010

目的分析重庆市2010年手足口病流行特征,为手足口病的防治提供科学依据。方法下载"疾病监测信息报告管理系统"疫情数据,描述病例流行病学特征,收集重庆市手足口病监测资料,分析死亡病例流行特征及实验室检测结果。结果 2010年报告病例19970例,重症42例,死亡26例,发病率为69.85/10万,死亡率为0.091/10万。4-5月为发病高峰,主城区比远郊区县高发,1～3岁组的散居儿童为高发人群。0～3岁男性散居儿童为手足口病死亡的高危人群,临床表现以高热、手足部出疹为主,伴有不同程度的神经、呼吸、循环、消化系统症状和体征。聚集性病例多发生在学校和幼托机构。荧光PCR检测阳性率为63.26%,轻症病例以柯萨奇病毒A16型为主(39.09%),但引起死亡的均为肠道病毒71型,病毒分离率为24.30%。结论手足口病疫情的防控重点应放在及时发现重症病例,加强重症病例的临床就治,降低死亡率等方面。

Objective To analyze the epidemiological characteristics of hand-foot-mouth disease（HFMD） in Chongqing in 2010,and provide a scientific basis for the prevention and treatment of HFMD.Methods The data from ＂disease surveillance and information management report system＂ were downloaded.The epidemiological features were described;surveillance data of Hand-foot-mouth disease were collected;the clinical chacteristics and laboratory results of death cases in Chongqing were analyzed.Results There were 19 970 cases in 2010.42 cases were serious and 26 cases of death.The incidence was 69.85/10 million,and the mortality was 0.091/10 million.The incidence reached the peak during the period from April to May.The incidence in major districts was higher than in remote regions.The sporadic children between the age of 1 year to 3 years were high risk susceptible population,but the male children from birth to 3 years were susceptible for death.The major clinical manifestations were high fever,rushes on the hand and foot,accompanied by varying degrees of symptoms of nervous,respiratory,circulatory and digestive systems.Clusters of case occurred mostly in school and kindergardens.The positive rate of fluoresence PCR was 63.26%.The mild cases were mostly caused by Cox A16 virus,however,all the dead ones were caused by EV71.The isolation rate was 24.30%.Conclusion The key ponit of preventing and controlling Hand-foot-mouth disease should be focus on the finding of serious cases in time,strenthening the clinical treatment and reducing the number of death case.