2017年1—5月全国手足口病疫情形势分析

Analysis on surveillance data of hand,foot and mouth disease in China,January-May 2017

目的在手足口病疫情上升期,分析2017年1―5月全国手足口病流行强度、严重程度、肠道病毒循环血清型的变化趋势及重点关注地区,进行风险提示,提出防控建议。方法利用《传染病报告信息管理系统》中手足口病监测数据,对2017年前5月的全国监测数据进行描述性分析并与2016年同期水平进行比较。结果 2017年1―5月,全国手足口病病例数、重症数和死亡数较2016年同期分别下降40.7%、39.7%和30.9%,但重症比例,病死率及重症死亡比例略高于2016年同期。轻症和重症病例以12~23月龄年龄组发病率最高,分别为7 940.4/100万和71.9/100万,6~11月龄死亡率最高,为1.1/100万。大部分省份病例数、重症数和死亡数较往年同期水平下降,但山东、陕西、山西、内蒙古和福建等省(自治区)重症数和(或)死亡数出现不同程度的增加。病原学监测结果显示,肠道病毒71型(EV71)和其他肠道病毒为优势循环,分别占41.4%和41.6%,其中轻症病例以EV71和其他肠道病毒感染为主,分别占40.2%和42.0%;重症病例和死亡病例仍以EV71感染为主,分别占61.9%和92.9%。以EV71为优势血清型的省份较2016年增加。结论手足口病疫情整体流行强度低于2016年同期,但疾病严重程度略高于2016年同期。部分省份受EV71构成增加、优势病原改变、易感人群积累致重症和死亡病例上升,应加强EV71疫苗免疫接种宣传,以降低重症、死亡发生。以其他肠道病毒为优势血清型的省份,尤其是重症病例中其他肠道病毒构成较高的省份,应加强血清型鉴定。

Objective To analyze the epidemic intensity and severity of hand,foot and mouth disease（HFMD） and changes of serotype of circulating pathogens in China during January-May 2017, and provide evidence for the early warning,prevention and control of HFMD epidemic. Methods The HFMD surveillance data were collected from National Notifiable Infectious Disease Reporting Information System for a descriptive epidemiologic analysis,the results were compared with the same period in 2016. Results During January-May 2017, the reported cases,severe cases and fatal cases of HFMD decreased by 40. 7%,39. 7% and 30. 9%respectively compared with the same period in 2016,but the severe case rate,case fatality rate and death rate of severe cases were slightly higher. The incidence rate was highest in children aged 12-23 months（mild cases： 7 940. 4/1 000 000; severe cases： 71. 9/1 000 000）. The mortality was highest in children aged 6-11 months（1. 1/1 000 000）. Compared with 2016, the reported cases,severe and fatal cases of HFMD decreased in most provinces,but severe cases and（or） fatal cases increased in Shandong,Shaanxi,Shanxi,Inner Mongolia and Fujian provinces. Virological surveillance indicated that enterovirus 71（EV71） and other enteroviruses were predominant pathogens,accounting for 41. 4%and 41. 6% respectively in laboratory-confirmed cases. In the mild cases,EV71 and other enteroviruses were predominant,accounting for 40. 2%and 42. 0% respectively. Severe and fatal cases were mostly caused by EV71（severe cases： 61. 9%,fatal cases： 92. 9%）. The number of provinces where EV71 was predominant increased in 2017. Conclusion The HFMDepidemic level was lower in China during January-May in 2017 compared with the same period in 2016,but the disease severity increased slightly. The increase of severe and fatal cases in some provinces was probably due to the increased proportion of EV71 infection,shift of predominant enterovirus serotype and susceptible population accumulation. The EV71 vaccine immunization should be promoted to reduce the incidence of the severe and fatal cases. Provinces where other enteroviruses were predominant,especiallythe province with high proportion of other enteroviruses in severe cases,should enhance the serotype identification of other enteroviruses.