2011—2014年湘西自治州手足口病流行病学特征分析

Analysis on epidemiological characteristics of hand-foot-mouth disease in Xiangxi Tujia and Miao Autonomous Prefecture from 2011-2014

目的分析湖南省湘西自治州手足口病流行病学特征,为制定防治对策提供科学依据。方法采用描述流行病学方法对2011—2014年湘西自治州手足口病疫情和实验室检测结果进行分析。结果湘西自治州2011—2014年共报告手足口病33 445例,其中重症1 601例,死亡7例,年均发病率为326.25/10万,2012年发病率比2011年增加179.48%,2014年发病率比2013年增加174.85%,不同年份间发病率差异有统计学意义(P<0.01)。2011—2014年发病呈现双高峰,春夏季高峰在4—7月,秋季高峰在10—11月。2011、2013年实验室检测病毒型别构成以其他肠道病毒为主,2012年实验室检测以EV 71为主,2014年实验室检测EV 71、Cox A 16、其他肠道病毒阳性分别占35.28%、22.31%、42.41%。各县(市)均有病例报告,吉首市报告发病率最高,为799.20/10万。病例年龄主要在5岁以下,占92.42%;职业分布以儿童为主,散居儿童占发病总数的79.40%,其次为幼托儿童,占17.64%。结论湘西自治州手足口病疫情呈2年流行1次,存在明显时间、地区、性别、年龄差异;疫情流行年手足口重症病例增加,EV 71检出率上升。要加强手足口病监测,落实乡镇卫生院对普通手足口病病例的诊断、治疗和管理。

[Objective] To analyze the epidemiological characteristics of hand-foot-mouth disease（HFMD） in Xiangxi Tujia and Miao Autonomous Prefecture,provide scientific evidence for developing the prevention and control measures of HFMD.[Methods]The epidemic data and laboratory test results of HFMD in Xiangxi Tujia and Miao Autonomous Prefecture from2011-2014 were analyzed by the descriptive epidemiological method.[Results]A total of 33 445 HFMD cases were reported in Xiangxi Autonomous Prefecture from 2011-2014,and there were 1 601 serve cases and 7 death cases. The average annual incidence was 326.25/lakh. The incidence in 2012 increased by 179.48% as compared with that in 2011,while the incidence in2014 increased by 174.85% as compared with that in 2013,and the difference in the incidence was statistically significant among different years（P〈0.01）. There were two peak seasons,which the spring and summer peak appeared April to July,and the summer peak appeared October to November. The major pathogen of cases were other enteric virus in 2011 and 2013,EV71 was the major pathogen of HFMD in 2012,and the cases of EV71,Cox A 16 and other enteric virus respectively accounted for 35.28%,22.31% and 42.41% in 2014. The cases were reported in every city/county,and the incidence rate in Jishou City was the highest,which was 799.20/lakh. 92.42% of patients were children under five years old. Most of the cases were scattered living children（79.40%）,followed by the preschool children（17.64%）.[Conclusion]The epidemic of HFMD has occurred every two years in Xiangxi Tujia and Miao Autonomous Prefecture,and has the obvious differences in time,region,gender and age. The severe cases are increasing gradually and the detection rate of EV71 has increased. It is necessary to strengthen the HFMD monitoring,and implement the diagnosis,treatment and management of HFMD cases in township health centers.