2009-2014年四川省泸州市手足口病流行特征及病原学监测

Epidemiological and Etiological Surveillance on Characteristics of Hand-foot-mouth Disease in Luzhou,2009-2014

目的分析四川省泸州市手足口病流行特征,为制定防控措施提供依据。方法采用描述流行病学方法对泸州市2009-2014年手足口病资料进行分析。结果 6年累计报告手足口病4 036例,其中重症14例、死亡7例,年均报告发病率为15.77/10万,居全市丙类传染病第3位,病死率为0.17%,发病率以及在丙类中的位次呈上升趋势。全年各月均有病例报告,5-6月、10-11月为流行高峰,呈双峰流行;城区发病率高于农村、重症发生率低于农村（P〈0.05）;男女比为1.73∶1,5岁以下儿童发病为主（93.29%）,幼托儿童占有较大比例（25.40%）,聚集和暴发疫情呈上升趋势,主要发生在幼儿园。近5年实验室确诊906例,肠道病毒71型（EV71）、柯萨奇病毒A16型（Cox A16）、其他肠道病毒各占25.94%、38.52%和35.54%;重症病例、散发病例与聚集病例的病原分布差异有统计学意义,EV71是造成重症和死亡的主要毒株。结论四川省泸州市手足口病呈上升趋势,多种肠道病毒交替流行或共同流行。5岁以下儿童为重点防控人群,托幼机构是重点防控场所。感染EV71者容易发展成重症并导致死亡,提高重症病例的早发现和医疗救治能力可有效降低病死率。

Objective To analyze the epidemiological characteristics of hand- foot- mouth disease（ HFMD） in Luzhou,to provide a basis for the development of prevention and control measures. Methods Descriptive epidemiology method was used for data analysis in 2009-2014 HFMD in Luzhou. Results A total of 4036 HFMD cases were reported in the 6 years. Among which there were 14 severe cases and 7 death cases. The average annual incidence rate was 15. 77 / 105 and the mortality was 0. 17%. Both the incidence and the rank in class C were rising. Cases were reported in every month,and reached the peak at June and November. Urban areas reported higher incidence and less severe cases than rural areas（ P〈0. 05）. The sex ratio of the cases was 1.73： 1; most（ 93. 29%） cases were under 5 years old and 25. 40% were kindergarten children. Cluster cases and outbreaks emergencies were on the rise. There were906 cases laboratory-confirmed in past 5 years,including enterovirus 71（ EV71）, Coxsackie virus type A16（ Cox A16）,other enteroviruses with the proportions of 25.94%,38. 52% and 35. 54% respectively. The pathogen distribution of severe cases and general cases were different with statistically significant, EV71 was the main pathogen of severe and death. Conclusion Hand-foot-mouth disease is rising in Luzhou. Most infections were EV71 and Cox A16. Children under 5 years of age are the focus groups and kindergartens were the focus sites for disease prevention and control. EV71 infection is more vulnerable to severe ones and easy leads to death. Early detection and treatment capacity can effectively reduce mortality.