广州市2008-2012年手足口病疫情分析

Epidemic situation analysis of hand,foot and mouth disease in Guangzhou city during 2008- 2012

目的了解广州市2008-2012年手足口病流行病学特征,为手足口病防治提供科学依据。方法采用描述性流行病学方法对2008-2012年疾病监测信息报告系统报告的广州市手足口病病例进行流行病学分析。结果广州市2008-2012年共报告15 6895例手足口病病例,重症117例,死亡12例,年平均发病率为268.34/10万。其中2008年报告6 230例,发病率为57.02/10万;2009年报告14 149例,发病率为128.53/10万;2010年报告35 373例,发病率为319.14/10万;2011年报告46 141例,发病率为363.29/10万;2012年报告55 002例,发病率为431.34/10万。发病主要有两个高峰期,一个主要的高峰期集中在4~6月,另一个在9~10月。病例主要集中在5岁及以下儿童,占发病总数的95.07%（149 160/156 895）,其中3岁及以下儿童病例占发病总数的81.74%（128 247/156 895）。死亡病例均为9~32月龄儿童。2008-2012年共报告手足口病实验室确诊病例11 826例,其中普通病例11 729例、重症病例97例。重症病例和普通病例病原构成存在差异,重症病例中肠道病毒71型（EV 71）构成比为74.23%（72/97）,柯萨奇病毒A16型（Cox A16）构成比为11.34%（11/97）;普通病例中EV 71构成比为26.29%（3 084/11 729）,Cox A16构成比为34.74%（4 074/11 729）。2008-2012年共发生聚集性病例疫情47起,托幼机构45起,占95.74%;聚集性病例发生时间主要集中在4~7月,共报告30起,占63.83%（30/47）。结论 2008-2012年手足口病流行强度呈逐年增强趋势。5岁以下儿童尤其是3岁及以下儿童是发病主要人群,EV 71和Cox A16为主要病原,重症病例主要由EV 71引起。聚集性病例高发场所为托幼机构。

Objective To describe the epidemiological characteristics of reported hand,foot and mouth disease（ HFMD） cases in Guangzhou during 2008-2012,provide scientific evidence for the prevention and control.Methods We used descriptive epidemiological method to analyze the epidemiological data of HFMD from the Chinese national infectious diseases reporting system during 2008- 2012. Results A total of 156,895 HFMD cases,including 117 severe cases,12 deaths,with the annual average incidence of 268. 34 /100,000. There were 6,230,14,149,35,373,46,141 and 55,002 HFMD cases were reported from 2008 to 2012 in Guangzhou respectively. The reported incidence was 57. 02 /100,000,128. 53 /100,000,319. 14 /100,000,363. 29 /100,000 and 431. 34 /100,000,respectively. The incidence peak occurred during April- July and sub- peak occurred during September- October of a year. HFMD cases were concentrated mainly in 5year- old or even younger children,accounted for 95. 07%（ 149 160 /156 895） of the total cases,of which were children under 3 years old and accounted for 81. 74%（ 128 247 /156 895） of total. Severe cases were children aged 9- 32 months. HFMD laboratory confirmed cases 11,826,of which common cases 11,729,severe cases 97. There was a difference in the pathogens between severe cases and common cases,74. 23% of which were caused by enterovirus 71（ EV71） and 11. 34% of which were caused by Coxsackie virus A16（ CoxA16） in severe cases. EV71 accounted for 26.29% and those caused by CoxA16 accounted for 34.74%in common cases. There were 47 clusters of cases during 2008- 2012,of which 45 found in preschools,accounted for 95. 74% of total. Outbreaks occurred mainly in April to July,30 outbreaks were reported,accounted for 63. 83%（ 30 /47） of total. Conclusions The HFMD epidemic intensity was increasing during2008- 2012,children under 5 years old and especially less than 3 years old were the major population groups at risk,EV71 and CoxA16 were both the major etiologic agents of HFMD,severe cases were caused mainly by EV71. Preschools were the main places where clusters of cases occurred.