儋州市 2010—2014 年手足口病重症病例流行病学特征分析

Epidemiological characteristics of the severe cases of hand, foot and mouth disease in Danzhou from year 2010 to 2014

目的 分析儋州市手足口病重症病例的流行病学特征,为手足口病重症病例防制提供依据. 方法 应用描述性流行病学统计方法,对2010—2014年儋州市手足口病重症病例进行流行病学分析. 结果 儋州市2010—2014年共报告手足口病18 960例,其中重症病例188例（含死亡病例,下同）,重症发生率0.99%,死亡6例,病死率0.13%. 87.77%的重症病例发生在2岁以下,男女性别比为2 .4 ：1 ,96 .28%为散居儿童,发病高峰在6—7月,农村地区重症病例发生率比城镇地区高.农村地区和城镇地区患儿初诊为手足口病普通病例时间差异无统计学意义,但是从发病到诊为手足口病重症病例时间差异有统计学意义（M-W检验,P〈0.05）;188例重症病例中82.44%的普通病例由县级医疗机构初诊,90 .96%的重症病例由地市级及以上医疗机构诊断. EV71阳性检出率44 .15%.结论 2010—2014年儋州市手足口病重症病例主要发生于农村2岁以下散居儿童. 通过在居民中有针对性地开展宣传教育,提高医务人员早期识别水平,加强病原学监测,及时预测预警等综合防控措施,从而降低重症病例的发生率和死亡率.

Objective To analyze the epidemiological characteristics of the severe cases of hand , foot and mouth disease （ HFMD） in Danzhou and to provide a scientific evidence for the prevention of severe HFMD.Methods Descriptive epidemiological analysis was used to analyze the characteristics of severe ca -ses of HFMD occurred from 2010 to 2014 .Results A total of 18 960 cases of HFMD were reported in Danzhou City from 2010 to 2014.The death rate （annual deaths/1000 persons） was 0.13%.One hundred and eighty-eight cases （0.99%） were diagnosed as severe HFMD with a male to female ratio of 2.4 ：1 and 96.28%of them were scattered inhabiting children .Six cases were died from severe HFMD and all of them were under 2 years of age.In total 87.77%of the severe cases were occurred in children under 2 years of age.The severe cases were mainly occurred in June and July .Children form the countryside showed higher rates of severe HFMD than those from cities and towns .No significant differences in the time between the in-itial diagnosis and treatment for children with HFMD in countryside and urban areas were found .However , the differences in the duration from initial diagnosis to severe HFMD between children in countryside and ur -ban areas were statistically significant （M-W test, P〈0.05）.Among the 188 severe cases, 82.44% were initially diagnosed as common HFMD cases by the county-level medical institutions and 90.96%were diag-nosed as severe cases by the municipal and above medical institutions .The cases positive for EV71 strains accounted for 44.15%.Conclusion Most of the severe HFMD were developed in scattered inhabiting chil-dren under 2 years of age in the countryside of Danzhou during 2010 to 2014.In order to decrease the mor-bidity and mortality of severe HFMD in children , it is necessary to implement health education for residents , to improve the professional skills of medical staffs in the early diagnosis of HFMD , and to strengthen etiologi-cal surveillances and warning system for HFMD .