2008—2014年广西手足口病流行病学及病原分布特征

Epidemiology and pathogen distribution of hand-foot-mouth disease in Guangxi,2008-2014

] 目的分析广西2008-2014年手足口病流行病学及病原分布特征,为防控手足口病提供依据.方法采用描述性方法对手足口病疫情资料进行统计分析,用Real time RT-PCR 方法对病毒核酸进行检测.结果广西7 年累计报告手足口病1 158 419 例,年均发病率为400.56/10 万;重症9 619 例,死亡494 例,病死率为0.04%,发病高峰为4-7 月,以3 岁及以下散居和幼托儿童为主.轻症和重症死亡病例中EV71 阳性率分别为21.66%、60.45%,差异有统计学意义（χ2=4 605.26,P〈0.001）;7 年间主要病原体依次为其他肠道病毒、CoxA16、EV71、CoxA16、EV71、其他肠道病毒、EV71;重症死亡病例与EV71 感染高度相关（r=0.992,P〈0.001）.结论广西手足口病流行危害严重,主要危害3 岁及以下散居和幼托儿童;主要病原体逐年变迁;EV71 是导致重症及死亡的主要病原体。

Objective To analyze the epidemiological characteristics and pathogen distribution of hand-foot-mouth diseases(HFMD) in Guangxi Province from 2008 to 2014,and provide evidence for prevention and control. Methods The monitoring data of HFMD from 2008 to 2014 was analyzed with descriptive epidemiology, and the virus nucleic acid was detected by real-time fluorescence RT-PCR method. Results A total of 1 158 419 HFMD cases including 9 619 severe and 494 deaths were reported from 2008 to 2014, the incidence rate was 400.56/100 000 and the fatality rate was 0.04%.The peak of incidence rate was from April to July in each year. A majority of the cases was scattered children and preschool children aged from 0 to 3 years. The positive rates of EV71 in the mild , severe/death cases were 21.66% and 60.45% respectively, and the differences between the two groups were significant(χ2=4 605.26,P<0.001). The types of predominant viruses changed year by year, which were the other species of intestinal viruses, CoxA16, EV71, CoxA16, EV71, other species of intestinal viruses, and EV71 respectively in 2008 to 2014. There was highly correlation between severe/death cases and EV71 (r=0.992,P<0.001). Conclusion The epidemic situation of HFMD in Guangxi province is quite serious, scattered children and preschool children under 3 years old were at high-risk. The types of predominant virus changed year by year. The majority of severe and death cases was caused by EV71.