江苏省5岁以下儿童2009—2014年手足口病流行病学特征

Epidemiology and etiology of hand-foot-and-mouth disease among children under 5 years old in Jiang Su province during 2009 to 2014

目的描述江苏省2009—2014年5岁以下儿童手足口病的流行病学和病原学特征,为手足口病的防制提供科学依据。方法采用现况研究的方法,对江苏省2009—2014年5岁以下儿童手足口病发病情况进行统计和分析,对部分手足口病例采用荧光定量RT-PCR法进行肠道病毒核酸检测。结果江苏省2009—2014年5岁以下儿童手足口病平均发病率为2 503.77/10万,2012年和2014年呈现发病高峰,各年份的4—7月为发病的主高峰,11—12月为次高峰;发病率依次为苏南地区（2 711.9/10万～7 592.2/10万）高于苏中地区（1 995.0/10万～6 105.1/10万）高于苏北地区（788.2/10万～1 823.8/10万）;各年龄组男童手足口病发病率均高于女童（P值均〈0.01）;2岁组的发病率最高,其次为3岁组和1岁组,重症病例中男童多于女童,3岁及以下儿童占重症病例总数的比例为79.28%～84.14%;散居儿童普通和重症发病率均高于幼托儿童。普通病例中,EV71感染阳性占37.77%,Cox A16阳性占35.32%;而重症病例中EV71感染阳性占79.83%,Cox A16阳性占6.52%。结论江苏省5岁以下儿童手足口病流行具有明显的季节性、地区性和易感人群分布特征,普通病例流行的病原体主要为EV71和Cox A16,且不同年份间流行优势株有所差别。

Objective To describe the epidemiological and etiological characteristics of hand-foot-mouth disease（ HFMD）among children under 5 years old in Jiangsu Province, and to provide scientific evidence for effective prevention and control of HFMD. Methods A descriptive epidemiological method was used on the surveillance data from National Disease Supervision Information Management System of HFMD. Nucleic acid of enterovirus（ EV） in blood samples of laboratory testing cases was detected by real-time RT-PCR. Results The average incidence rate of HFMD was 25 037.72 per million during 2009 to 2014, the peak incidence occurred in 2012 and 2014, and the annual peak incidence occurred in April to July. There were significant regional differences, and was highest in the densely inhabited southern areas（ 27 11.9 / 100 000 ～ 7 592.2 / 100 000） of Jiangsu province. Most of the cases were children under 3 years old. The incidence rate in male was higher than in female and scattered children was higher than in kindergarten children. Among mild HFMD cases, the ratios of EV71 and Cox A16 infection accounted for 37.77%, 35.32%,respectively. While the ratios of EV71 infection sharply increased by 79.83%, Cox A16 infection only accounted for 6.52% in severe cases. Conclusion HFMD in Jiangsu province during 2009-2014 has close relation with season, population and region. Mild cases of HFMD are mostly infected by EV71 and Cox A16, while EV71 is also associated with serious complications which might be fatal.