儋州市2011-2013年手足口病流行病学特征分析

Analysis of the epidemiological characteristics of hand-foot-and-mouth disease in Danzhou between 2011 and 2013

目的 了解儋州市手足口病流行病学特征并分析其影响因素,为制定有效的手足口病防控策略提供科学依据.方法 通过描述性流行病学方法,对儋州市2011-2013年网络直报的手足口病进行分析.结果 2011-2013年儋州市共报告手足口病病例12 314例,其中重症78例,死亡3例;2011-2013年手足口病报告发病高峰在9～10月,发病时间分别集中在5～7月、9～11月和8～10月;各地区均有病例报告,发病率居前五的是兰洋镇、那大镇、龙山农场、西培农场和南丰镇;男性病例8 365例,女性3 949例,男女性别比2.1：1;发病年龄集中在0～3岁90.08%（11 092/12 314）,其中以1岁居多,占全市报告手足口病发病数的40.87%（5 033/12 314）;职业人群分布以散居儿童为主,占88.65%（10 916/12 314）;实验室检测结果显示,不同的年度流行的血清型不同,2011年以EV71为主,2012和2013年以CoxA16为主;重症病例发生率无性别和年龄差异,农村地区重症发生率为0.76%,高于城区或乡镇的0.46%,重症病例实验室检测以EV71为主;3例死亡病例均有反复多次基层医院治疗史;全市共报告聚集性病例643起,以家庭型为主,占67.34%,2011-2013年无暴发疫情报告.结论 儋州市普通手足口病发病率在性别、年龄、职业和地区上有明显差异.在重点地区和重点人群中开展疫情监测和根据流行病学特征制定防控方案是手足口病防控基础,加强宣传教育和提高医务人员对重症手足口病早期识别和救治能力是降低重症危害的关键.

Objective To analyze the epidemic characteristics of hand-foot-and-mouth disease （HFMD） in Danzhou, and to provide scientific basis for HFMD prevention. Methods Online reports of HFMD patients in Dan-zhou from 2011 to 2013 were analyzed using descriptive epidemiological method. Results A total of 12 314 HFMD cases were reported, including 78 severe cases and 3 death cases. The incidence of HFMD reached the peak in Septem-ber and October. The onset of HFMD were concentrated between May and July, September and November, and Au-gust and October. The top five regions with high incidence of HFMD were Lanyang, Nada, Longshan, Xipei and Nan-feng. The ratio of female to male was 2.1：1 （8 365 male cases and 3 949 female cases）. Patients＆#39; age were mainly be-tween 0 to 3 （1 1092/12 314）, and most of them were at the age of one （5 033/12 314）. In terms of patients＇ occupa-tions, 88.65%of them were children （10 916/12 314）. Laboratory test results showed that there were different popular serotypes each year：it was EV71 in 2011, and CoxA16 in 2012 and 2013. There was no sex and age difference of the incidence of severe cases. The incidence of severe cases in rural area was 0.76%, higher than 0.46%in urban area or town. Laboratory test results showed that EV71 was the main serotype in severe cases. Repeated medical treatments were found in 3 death cases. A total of 643 clustered cases were reported and 67.34%of them were family-clustered cases. No outbreak was reported between 2011 and 2013. Conclusion There were significant differences of HFMD incidence in sex, age, occupation and area. Surveillance and prevention of HFMD should be carried out in key areas and key populations according to epidemic characteristics. The strengthening of public education and improvement of early recognition and treatment capacity of medical staff on HFMD is the key to reduce severe harm.