2012年南京市手足口病流行病学及病原学特征

Analysis on the epidemiological and etiological characteristics of hand-foot-mouth disease in Nanjing City in 2012

目的了解2012年南京市手足口病流行病学特征，为制定更加科学、有效的预防控制措施提供依据。方法采用描述流行病学的研究方法，对南京市2012年手足口病疫情资料及病原学监测资料进行分析。结果2012年全年南京市共报告手足口病17041例，发病率为210．16／10万；其中重症217例，重症病例占总病例的比例为1．27％。发病高峰发生在夏季（4—7月），次高峰发生在冬季（11和12月）。城郊、2县人群发病率均高于主城区（P〈0．01）。男女发病率之比为1．50：1（P〈0．01）。0～5岁儿童占总病例的92．41％，年龄别发病率差异有统计学意义（P〈0．01）。绝大多数病例为幼托儿童和散居儿童。2012年全市共报告实验室诊断病例646例，普通病例以CoxAl6和EV71感染为主，重症病例以EV71感染为主（P〈0．01）。结论南京市手足口病季节、地区、性别、年龄及人群分布特征明显。低龄、男性幼儿是手足口病的危险因素。延迟就诊的病例发展成重症病例的风险更大。手足口病的预防控制应以散居儿童和幼托儿童为重点人群，开展手足口病流行病学和病原学研究，将有助于提出更好的预防控制措施。

[ Objective] To understand the epidemiological characteristics of hand-foot-mouth disease （HFMD） in Nanjing City in 2012, provide the basis for formulating the scientific and effective prevention and control measures in the future. [Methods] By using the epidemiological method, the date of HFMD epidemic situation and etiological surveillance in Nanjing City in 2012 were analyzed. [Results] A total of 17041 HFMD cases were reported in Nanjing City in 2012, with the incidence rate of 210. 16/1akh, and there were 217 severe cases, which accounted for 1.27% of total cases. The peak season occurred in summer （April to July） , while the second peak was in winter （November to December）. The incidence rates in suburban area and two counties were higher than that in main urban area （P 〈 0.01）. The ratio of male-to-female was 1.50： 1 （P 〈 0.01）. The children aged 0 to 5 years old accounted for 92. 41 % of the total cases, and there was significant difference in incidence rate among different age groups （ P 〈 0. 01 ）. Most of cases were kindergarten children and scattered children. Among the reported cases, 646 were confirmed by laboratory detection. The mild cases mainly infected by CoxA16 and EV71 , while the severe cases were mainly caused by EV71 infection （P 〈 0. 01 ） . [ Conclusion] There are obvious characteristics in season, region, gender, age and population distribution of HFMD in Nanjing City . Younger and male children are high risk population of HFMD, and delayed treatment increases the risk of developing into severe cases. The kindergarten children and scattered children are the key population for the prevention and control of HFMD, and epidemiological and etiological studies can help to develop prevention and control measures of HFMD.