湖北省2008-2011年手足口病流行病学特征分析

Epidemiological characteristics of hand-foot-mouth diseases in Hubei Province(2008-2011)

目的分析湖北省2008-2011年手足口病流行病学特征,为手足口病的防控提供科学依据。方法采用描述性流行病学方法,对湖北省2008-2011年手足口病疫情监测资料进行统计分析。结果湖北省2008-2011年手足口病报告病例来自13个市(州)、3个省直管市、1个林区、103个县(区),共报告187 905例,其中重症347例,死亡51例;常年均有发病,发病时间呈双流行高峰(4～7月为主高峰,占62.11%;11～12月为次高峰,占16.42%);病例以4岁以下儿童为主,共172 159例,占91.62%;男女发病数比为1.80∶1,差异有统计学意义(χ2=34.86,df=3,P<0.01);病原学检测结果显示普通病例中肠道病毒71型(EV71)阳性率为52.18%(2 667/5 111),科萨奇病毒A16型(Cox A16)阳性率为27.27%(1 394/5 111),其他肠道病毒阳性率为20.54%(1 050/5 111);死亡和重症病例EV71阳性率分别为78.32%及94.87%。暴发疫情共18起(1 875例),以托幼和散居儿童为主(90.03%)。结论湖北省手足口病的流行形势较为严峻,应重点关注4～7月份的疫情,4岁以下的散居儿童、幼托儿童及EV71感染者是重点防控的对象。

Objective To analyze the epidemiological characteristics of hand-foot-mouth diseases in Hubei Province from 2008 to 2011, and provide evidence for prevention and control. Methods The monitoring data of HFMD from 2008 to 2011 in Hubei Province was analyzed with descriptive epidemiology. Results 187 905 cases, including 347 severe cases and 51 death cases, were reported from 13 cities, 3 cities （under direct provincial jurisdiction）, 1 forest region and 103 counties in Hubei Province from 2008 to 2011. HFMD had two seasonal peaks of incidence （62.11% of the cases were reported from April to July, and 16.42% were reported from November to December）. Most of the cases were children under four years old, accounted for 91.62 percent, with a total number of 172 159. The number of male cases was more than female （ X2 = 34.86, df = 3, P 〈 0.01 ） ; Etiological analysis revealed that enterovirus 71 （ EV71 ） was the major pathogens of HFMD, with positive rate of 52.18%, while positive rate of Coxsackie virus A16（ Cox A16） and other enterovirus were 27.27% and 20.54%, respectively. EV71 positive rate of severe and death cases were 78.32% and 94.87% respectively. The total number of outbreak was 18 （ 1 875 cases）, and most of the cases were scattered living children and preschool children. Conclusions The epidemic situation of HFMD in Hubei province is quite serious, more attention should be paid during April to July. Scattered living children and preschool children under 4 years old and those infected by EV71 are the focus of prevention and control.