2010-2014年杭州市拱墅区手足口病疫情流行特征

Epidemiology of hand foot and mouth disease in Gongshu district of Hangzhou,2010-2014

目的分析2010 2014年杭州市拱墅区辖区手足口病的流行特征,为进一步掌握疫情动态,有效防控手足口病发生、开展预警和预测等相关研究提供依据。方法收集整理2010 2014年拱墅区辖区人口、手足口病发病数、聚集性疫情和暴发疫情以及手足口病病原学监测资料,采用描述性流行病学方法对辖区手足口病的三间分布进行分析。结果 2010 2014年拱墅区共报告手足口病2576例,年平均发病率为99.43/10万,报告重症病例1例,无死亡病例,2010 2013年发病较为平稳,2014年增幅较大,上升至182.70/10万;季节性明显,4 7月为高峰,9 10月为次高峰;男女性别比为1.51∶1;发病人群以5岁以下儿童为主,占96.43%,以散居儿童和幼托儿童为主,占97.79%。各街道均有发病,主要集中在城郊结合部,其中祥符街道发病率最高;全区共发生聚集性疫情42起,主要集中在学校和托幼机构,占总数的80.95%;病原学监测显示,优势病原体由2012 2013年其他肠道病毒为主转变为2014年其他肠道病毒和肠道病毒71型共同作用。结论拱墅区手足口病具有周期流行的规律,流行有明显的季节性和人群分布特点,散居和幼托儿童是拱墅区的高发人群,应进一步加强对重点人群和重点场所的手足口病防控,同时在做好日常监测和病原学监测基础上开展疫情风险分析。

Objective To investigate the epidemiological characteristics of hand foot and mouth disease（ HFM D） in Gongshu district of Hangzhou from 2010 to 2014 and provide evidence for the local control and early warning of HFM D.Methods Descriptive epidemiological analysis was conducted on the incidence and pathogen surveillance results of HFM D in Gongshu during this period. Results A total of 2576 HFM D cases,including 1 severe case,were reported without death. The average incidence rate was 99. 43/lakh. The annual incidence during 2010- 2013 was relatively stable,but in 2014 it increased obviously to 182. 70/lakh. The incidence peak of HFM D was during April-July and the sub peak occurred during September-October. The male to female ratio of the cases was 1. 51 ∶ 1. The cases aged 0- 5years accounted for 96. 43% of the total. Most cases were children outside child settings or preschool aged children,accounting for 97. 79%. The cases were reported in all the communities,especially in the suburban area,and the incidence rate was highest in Xiangfu. A total of 42 HFM D outbreaks occurred,which mainly affected schools and child care settings,accounting for 80. 95%. The main pathogens causing HFM D changed from only other enterovirus during2012- 2013 to both EV71 and other enterovirus in 2014. Conclusion The incidence of HFM D was stable in Gongshu during 2010- 2014,but the seasonality and population distribution of HFM D were obvious. Children outside child care settings or preschool aged children was the major high risk population,It is essential to strengthen the prevention and control of HFM D in risk groups and places,and it is necessary to carry out the epidemic risk analysis of HFM D based on routine monitoring and etiological surveillance.