上海市浦东新区2009—2012年手足口病疫情流行病学分析

Epidemiological Analysis of Hand-Foot-Mouth Disease in Pudong New Area, Shanghai, 2009-2012

[目的]分析2009—2012年上海市浦东新区手足口病流行病学特征,为进一步掌握疫情动态,有效防控手足口病的发生、开展预警和预测等相关研究提供依据。[方法]收集整理2009—2012年浦东新区人口、手足口病疫情数据,采用描述流行病学方法对手足口病总体发病的三间分布情况、聚集性疫情和暴发疫情以及手足口病病原学监测资料进行分析。[结果]2009—2012年浦东新区共报告手足口病37 345例,其中重症149例,死亡7例。2009年发病率为120.49/10万,2012年上升至248.33/10万;季节性明显,5—7月为高峰,11—12月为次高峰;男女性别比值为1.59;5岁以下儿童发病占93.09%;以散居儿童和托幼儿童为主,占95.79%。浦东新区各街道、镇均有发病,街道中发病率最高为207.68/10万。镇中发病率最高为294.30/10万;全区发生聚集性病例1 566起,主要分布于托幼机构;实验室检测表明,病原体以柯萨奇A16(CoxA16)和肠道病毒71型(EV71)型为主。[结论]浦东新区手足口病有逐年上升的态势,发病有明显季节、性别、年龄特征。建议在做好日常监测和实验室病毒流行监测基础上开展手足口病疫情预警、预测研究。

[ Objective ] To describe the epidemiological features of hand-foot-mouth disease （HFMD） in Pudong New Area of Shanghai from 2009 to 2012 for control and early warning of HFMD in local residents. [ Methods ] Data of study population and HFMD cases in Pudong New Area were collected during a four-year timeframe （2009-2012） for descriptive epidemiological analysis on incident distribution, clusters, outbreak, and pathogen surveillance of HFMD. [ Results ] From 2009 to 2012, a total of 37 345 HFMD cases were reported including 149 severe cases and ？ fatalities. The estimated incidence rate of HFMD was 120.49/105 in 2009 and increased to 248.33/105 in 2012. A seasonal variation of HFMD incidence was also found, with a peak from May to July, followed by a minor peak from November to December. The male-to-female ratio was 1.59. Children under five years old accounted for 93.09% of the total reported cases. Children in geographically dispersed families and those in nurseries or kindergartens composed 95.79% of the reported cases. All subdistrcts and towns of Pudong New Area reported HFMD cases, and the highest incidence rate was 207.68/10s among the subdistricts and 294.30/105 among the towns. A total of 1566 clustered outbreak events of HFMD largely affected children in nurseries and kindergartens. CoxA16 and EV71 were the main pathogens. [ Conclusion ] The HFMD incidences are increasing with explicit seasonal variation and gender and age preponderance in Pudong New Area during 2009-2012. We should further study early warning and prediction of HFMD based on routine monitoring and laboratory testing.