2010—2014年南宁市手足口病流行病学特征

Epidemiologic features of hand-foot-mouth disease in Nanning City from 2010-2014

目的分析近年南宁市手足口病(HFMD)分布特点和流行趋势,为制定HFMD防制对策提供依据。方法从《国家疾病监测信息报告管理系统》和《突发公共卫生事件报告管理信息系统》分别收集2010—2014年7月南宁市报告的HFMD病例资料和暴发及聚集性疫情的现场调查资料,用描述流行病学方法进行分析。结果 2010—2014年7月南宁市共报告HFMD 230 874例,重症2 042例,死亡76例。为5岁及以下儿童发病221 617例,发病率为8 280/10万,占发病总数的95.99%。全年各月份均有病例出现,发病高峰在4—7月,其病例数占总病例数的62.38%,职业以散居和幼托儿童为主,分别占总病例数的70.97%和26.32%。实验室诊断3 144例,其中肠道病毒71(EV71)型占44.27%,柯萨奇病毒A16(Cox A16)型占24.49%;HFMD死亡儿童感染的病毒主要为EV71型,占死亡总数的82.89%。近5年来,南宁市发生5例以上的聚集性HFMD疫情50起,其中49起发生在托幼机构。结论南宁市HFMD发病呈逐年上升趋势,隔年出现以EV71型为主的流行,重症和死亡病例也增多,对此应加强研究5岁以下儿童的防治。

[Objective] To analyze the distribution characteristics and epidemiological trends of hand-foot-mouth disease （HFMD） in Nanning City, provide scientific basis for making prevention and control countermeasures.[ Methods ] The data of HFMD cases and aggregation epidemic in Nanning City from July 2010 to July 2014, which were respectively collected by the National disease surveillance information management system and the Emergent public health event report management information system, were analyzed by the descriptive epidemiological method. [ Results ] A total of 230 874 HFMD cases were reported in Nanning City from July 2010 to July 2014, including 2 042 severe cases and 76 death cases. 221 617 cases were children under 5 years old, accounting for 95.99% of the total cases, and the incidence rate was 8 280/lakh. The cases were reported in every month, and the peak season appeared April to July, which the cases accounted for 62.38% of the total cases. The scattered children and kindergarten children respectively accounted for 70.97% and 26.32%. Among 3 144 cases confirmed by laboratory examination, 44.27% were positive for enterovirus 71 （EV71） and 24.49% were positive for Coxsackie virus A16 （CoxA16）. The death cases were mainly infected by EV71, accounting for 82.89% of all death cases. There were 50 aggregation epidemic events of HFMD in Nanning City in recent 5 years, and 49 occurred in kindergarten.[Conelusion] The incidence rate of HFMD has increased year by year in Nanning City. The epidemic situation dominated by EV71 has appeared every other year, and the severe cases and death cases have increased significantly. Therefore, it is urgent to focus on the prevention and treatment in children under 5 years old.