2008-2011年福建省宁德市手足口病重症及死亡病例分析

Severe and fatal cases of hand,foot mouth disease in Ningde,Fujian,2008-2011

目的分析福建省宁德市2008-2011年手足口病重症及死亡病例流行病学特征,为早期识别和救治危重病例积累经验,降低病死率;制定科学的手足口病防控措施。方法收集整理2008-2011年宁德市各医疗机构报告的手足口病疫情报告卡、重症、死亡病例流行病学调查信息及实时荧光定量聚合酶链反应实验室检测结果,运用描述流行病学方法进行分析。结果宁德市2008-2011年共报告手足口病16 760例,重症80例(4.77‰),死亡6例(0.36‰),各年的重症发生率分别为1.63‰、1.45‰、7.23‰和4.93‰。4-10月为重症病例发生高峰,≤3岁儿童重症病例占83.75%,重症病例病原学以肠道病毒71型(human Enterovirus 71,EV71)为主。6例死亡病例发病年龄均为≤3岁,感染的病毒型别均为EV71型,临床特点是早期症状主要以高热为主,皮疹不明显,多数病例在乡村诊治没有被医生识别,病情突然加重短时间内死亡。结论宁德市手足口病疫情呈现逐年上升趋势,重症病例相继增多,死亡病例时有发生。今后应重点加强对重症病例的监测,早期发现和识别重症病例,避免死亡病例的发生。

Objective To understand the epidemiological characteristics of severe and fatal cases of hand,foot and mouth disease（HFMD） in Ningde,Fujian province,during 2008-2011 and provide evidence for the early diagnosis of HFMD and the development of prevention and control strategies.Methods Descriptive epidemiological analysis was conducted on the incidence data of HFMD,including the data of severe and fatal cases,and the results of real time quantitative PCR detection in Ningde during this period.Results A total of 16 760 HFMD cases,including 80 severe cases（4.77‰） and 6 deaths（0.36‰）,were reported from 2008 to 2011 with the annual incidence of 1.63‰,1.45‰,7.23‰ and 4.93‰ respectively.The annual incidence peak of severe cases was during April-October.Up to 83.75% of severe cases occurred in children aged ≤3 years and EV71 was the major pathogen.The 6 fatal cases were children aged ≤3 years after the infection of EV71.The early clinical manifestations of the severe cases was mainly high fever,rash was not apparent.Most fatal cases occurred rapidly duo to the misdiagnosis by village doctors in rural areas.ConclusionThe incidence of HFMD increased year by year with more severe cases and fatal cases reported in NIngde.It is necessary to strengthen the monitoring and the early diagnosis of severe cases to prevent the death causing by HFMD.