2010-2015年江阴市手足口病流行特征及疾病负担

Epidemic characteristics and disease burden of hand-foot-mouth disease in Jiangyin City from 2010-2015

目的了解2010—2015年江阴市手足口病的流行病学、病原学特征及重症病例的疾病经济负担,为江阴市手足口病的防控策略提供参考依据。方法选取江阴市2010—2015年的所有网络直报的手足口病病例,采用描述流行病学方法分析其三间分布及病原学特征。重症病例疾病经济负担的信息来自个案调查表。结果江阴市2010—2015年累计报告手足口病17 020例,年平均发病率为175.45/10万,每年4—7月有夏季流行主峰,10—12月有秋冬季流行次峰。发病人群主要集中在5岁及以下的儿童,男女性别比为1.47∶1。手足口病普通病例以EV71和Cox A16阳性为主,重症病例以EV71阳性为主。病原学构成方面重症病例与普通病例的差异有统计学意义(χ~2=54.06,P<0.01)。2010—2015年384例重症病例的疾病经济负担合计达9 731 750元,人均为25 343元。结论江阴市手足口病流行是具有明显的时间,地区及人群分布特征。该市手足口病防疫工作应以散居和幼托儿童为重点人群,以集体单位为重点场所,加强卫生宣教、消毒工作。同时,重症手足口病对社会和个人均有较重的经济负担,接种EV71疫苗不失为一种好的预防重症手足口病和减轻疾病经济负担的手段。

[Objective]To explore the epidemiological and etiological features of hand-foot-mouth disease（HFMD） and disease burden caused by severe cases in Jiangyin City from 2010-2015,provide evidence for prevention strategies of HFM D.[Methods]The network direct reporting cases of HFMD were analyzed by the descriptive epidemiology method to investigate the spatial,temporal and population distribution and etiological features. Individual questionnaires were applied to collect the disease burden caused by severe cases.[Results]There were altogether 17 020 HFMD cases reported from 2010 to 2015 in Jiangyin City,and the average annual incidence was 175.45/lakh. The primary epidemic peak appeared April to July（summer）while the secondary peak appeared October to December（autumn-winter）. Most of cases were children under 5 years old,and the male-tofemale ratio was 1.47 ∶ 1. The result of etiology suggested that EV71 and Cox A16 contributed to most of the mild cases,however the severe cases were almost caused by EV71. The difference in etiological constitution was statistically significant between severe cases and mild cases（χ~2=54.06,P〈0.01）. The total economic burden of 384 severe cases from 2010 to 2015 was 9 731 750 yuan（RMB）and the per capita economic burden was 25 343 yuan（RMB）.[Conclusion]The epidemic situation of HFMD shows obvious characteristics in spatial,temporal and population distribution in Jiangyin City. The prevention and control of HFMD should focus on scattered children and kindergarten children,as well as collective units,and strengthening the health education and disinfection.In addition,EV71 vaccination is one of the important measures for preventing severe HFMD and reducing economic burden.