广西2008-2015年手足口病流行病学特征及病原学监测分析

Epidemiology and pathogen surveillance of hand,foot and mouth disease from 2008 to 2015 in Guangxi,China

目的分析广西2008-2015年手足口病的流行病学特征及病原谱变化,为手足口病的防控提供理论依据。方法从疾病监测信息报告系统获取手足口病个案数据,采用描述性方法描述疾病的三间分布,荧光逆转录-聚合酶链式反应法检测病毒核酸。结果广西2008-2015年累计报告手足口病病例1 360 857例,双年份发病数、重症数及死亡数均高于前一年的单年份;发病高峰以4~7月为主,高发县(区)多集中在南宁市、柳州市和百色市,男女发病性别比为1.58∶1,以5岁以下儿童为主。8年间优势病原体依次变化,整体以其他肠道病毒和EV-A71为主,各年份不同病原构成之间的差异有统计学意义(χ~2=9 856.37,P<0.01);确诊病例病原构成按月分布呈现波浪形变化趋势,不同病例类型病原构成不同,轻症病例以其他肠道病毒为主,重症和死亡病例以EV-A71为主。结论广西手足口病严重危害儿童身心健康,优势病原体不断变化,主要病原是其他肠道病毒和EV-A71,且以其他肠道病毒为主。

Objective To analyze the epidemiological characteristics and pathogenic spectrum of hand, foot and mouth disease （HFMD） in Guangxi of China from 2008 to 2015. Methods Surveillance information of HFMD was collected from Chinese National Notifiable Infectious Disease Report System. The epidemiological characteristics were analyzed using descriptive epidemiologic methods. Real-time RT-PCR was used to detect virus nucleic acid. Results During 2008 to 2015, a total of 1 360 857 cases were reported in Guangxi of China. The number of mild cases, severe cases and mortality in double-digit years were higher than that in sin- gle-digit years. The main peak of incidence was observed from April to July. High risk areas were in Nanning, Liuzhou and Baise counties. Ratio of male to female was 1.58 ： 1. Children aged 0-5 years accounted for the ma- jority of the total cases. The type of predominant pathogens changed year by year~ other enteroviruses and EV- A71 were the major pathogens as a whole. There were significantly statistical differences in the pathogen com- positions of EV-AT1, CV-A16 and other enteroviruses at different years （X2 = 9 856.37, P〈0.01）. The monthly distribution of HFMD pathogens presented a wavy trend. The percentage of EV-A71 in double-digit years was higher than that in single-digit years. Pathogenic spectrum of HFMD in Guangxi was different. The major pathogens of mild cases and severe cases were other enteroviruses and EV-A71, respectively. Conclu- sions The predominant pathogens were constantly changing from year to year but the main pathogens were other enteroviruses and EV-AT1.