贵州省2014年手足口病聚集性/暴发疫情流行特征分析

A Study of epidemiological characteristic on the clustering nature of hand- foot- mouth disease( HFMD) in 2014 in Guizhou

目的了解贵州省2014年手足口病聚集性/暴发疫情流行特征。方法收集贵州省2014年手足口病病例个案资料、聚集性/暴发疫情调查报告和病原学检测数据,进行描述性流行病学分析。结果贵州省2014年共发生1 447起手足口病聚集性/暴发疫情,涉及病例4 627例,重症病例36例。分布于9个市（州）的84个县（市、区）,高发地区为遵义市（514起,占35.52%）、黔西南州（279起,占19.28%）和六盘水市（144起,占9.95%）。聚集发生地以农村（809起,占55.91%）居多,高于城市和城郊。发生场所以家庭聚集最多（665起,45.96%）,其次为幼托机构（438起,30.27%）,再次为混合聚集（175起,12.09%）;农村和城郊以家庭（57.60%和50.69%）居多,城区以托幼机构（67.61%）居多。疫情呈双峰分布,主峰为3~6月（1 009起,69.73%）,次峰为10~11月（156起,10.78%）。病例主要集中在5岁以下年龄组儿童,占81.37%（3 765/4 627）。肠道病毒检出率82.60%（470/589）,单一感染中Cox A16感染最多,占32.13%（151/470）;其次为其他肠道病毒感染,占25.96%（122/470）;混合感染以Cox A16＋其他肠道病毒感染居多,占8.94%（42/470）。结论贵州省2014年手足口病聚集性/暴发疫情分布广泛,家庭及幼托机构好发,病原多样,需加强健康教育和监测等。

Objective The study was to explore the epidemiological characteristic of the clustering nature of hand- foot- mouth disease（ HFMD） in 2014 in Guizhou Province,to provide with evidence for the policies making for the prevention and treatment. Methods Data of HFMD cases information involved in clustering epidemics including investigation and response information and etiologic surveillance information were collected in 2014 in Guizhou Province. All data were analyzed through descriptive method with Excel and SPSS 13. 0 softwares. Results A total of 1 447 HFMD clustering epidemics with 4 627 cases including 36 severe cases were reported in Guizhou Province in 2014. The clustering epidemics were distributed in 84 prefectures of all 9 prefectures. The prefectures with first 3 highest prevalent of clustering epidemics were Zunyi（ 514 clustering epidemics and accounting for 35. 52% of the total）,Qianxinan（ 279 clustering epidemics and accounting for 19. 28%） and Liupanshui（ 144 clustering epidemics and accounting for 9. 95%）. The clustering epidemics most likely happened in the rural areas（ 809 clustering epidemics reported and accounting for 55. 91% of the total） which was higher than that in city and suburban areas. The types of clustering epidemics were most as clustered in family（ 665 clustering epidemics and accounting for 45. 96%）,followed by clustered in childcare institutions（ 438 epidemics and accounting for 30. 27%）. The mixed clustered was the third type and accounted for12. 09% of the total（ 175 /1447）. In rural and suburban areas,clustered in family was the first common type（ accounting for57. 06% and 50. 69% respectively）,while clustered in kindergartens took the first place in city areas accounting for 67. 61%. The epidemic curve showed bimodal distribution in 2014,the main peak of the clustering epidemics occurred in the period from March to June reporting 69. 73%（ 1 009 /1 447）,the second peak ccurred in the period from October to November reporting10. 78%（ 156 /1 447）. 81. 37%（ 3 765 /4 627） of the cases reported involved in clustering epidemics were under 5 years old. The detection rate of enterovirus among the cases of clustering epidemics was 82. 60%（ 470 /589）. Among the single infection,Cox A16 was the most common（ 32. 13%）,followed by other intestinal virus infection accounted for 25. 96%. In mixed infection,the majority was EV 71 ＋ other enteroviruses infection（ 8. 94%）. Conclusion The clustering epidemics of HFMD are widely distributed in Guizhou Province,which have often been taken place in households and childcare institutions. The pathogens are of variety. Health promotion and surveillance programs should be strengthened in the future.