赤峰市2012—2015年手足口病流行特征及病原学分析

Epidemiological and etiological characteristics of hand,food and mouth disease in Chifeng city,2012-2015

目的分析内蒙古自治区赤峰市手足口病流行特征和病原谱变化,为采取有效的防控措施提供参考依据。方法收集国家疾病监测信息管理系统中2012年1月1日—2015年12月31日赤峰市上报的手足口病病历资料和病原学检测结果,分析手足口病的流行特征和病原谱变化情况。结果赤峰市2012—2015年共报告手足口病病例12 637例,年均发病率为72.74/10万,其中2012—2015年手足口病发病率分别为75.38/10万、59.32/10万、106.75/10万、49.43/10万,手足口病发病率较高且呈波浪式变化;发病时间主要集中在5—8月,4个月的手足口病发病例数为9 045例,占总发病例数的71.58%;发病年龄主要集中在1~6岁幼托和散居儿童,男女性别比为1.29:1;2012—2015年手足口病重症病例29例,占发病总数的0.23%,死亡2例,重症病例病死率为6.89%,全部病例病死率为0.02%;2012—2015年采集的2005份样本中,检出肠道病毒733份,阳性率为36.46%,其中EV71、Cox A16、其他肠道病毒分别占28.37%、21.28%、50.34%。Cox A16是2012年赤峰市优势病毒,EV71是2013年赤峰市优势病毒,2014、2015年则以其他肠道病毒为主要病原,赤峰市不同年份病原分布差异有统计学意义(χ~2=225.841,P<0.05)。结论赤峰市手足口病发病率较高且呈波浪式变化,病原以EV71、Cox16和其他肠道病毒为优势病原交替流行。

Objective To analyze epidemiological characteristics and pathogen variation of hand-foot-mouth disease （HFMD） in Chifeng city of Inner Mongolia Autonomous Region and to provide references for making effective preven- tion and control measures for the disease. Methods Data on reported cases and epidemic pathogen detection of HFMD in Chifeng city from January lst,2012 to December 31st,2015 were collected from National Disease Surveillance Infor- mation Management System and then analyzed with descriptive epiderniology methods. Results Totally 12 637 HFMD cases were reported in Chifeng city during the 4-year period and the average annual incidence rate of HFMD was 72. 74/100 000 ;the annual HFMD incidence rate fluctuated, with the yearly rates of 75.28/100 000,59. 32/100 000, 106. 75/100 000 ,and 49. 43/100 000 ,respectively. Of all the HFMD cases registered,71.58% （9 045 ）were reported be- tween May and August of a year; the majority of the reported HFMD cases were scattered living children aged 1 - 6 years ; the male to female ratio was 1.29 ： 1. Among all the HFMD cases,29 （0. 23 % ） were severe incidents and 2 of the severe cases died,with a case mortality rate of 6. 89% ;the case mortality rate was 0. 02% for all registered cases. Of all specimens sampled during the period,36.46% （733/2 005）were positive for enterovirus and of the positive specimens, 36.46% ,28. 37% ,and 50. 34% were positive for enterovirus 71 （ EV71 ）, Coxsackie virus A16 （ CoxA16 ）, and other enterovirus, respectively. The pathogen most frequently detected among the registered HFMD cases was CoxA16 in 2012, EV71 in 2013, and other enteroviruses in 2014 and 2015. The distribution of pathogens detected in the registered HFMD cases significantly varied yearly （X2 = 225.841, P 〈 0. 05 ）. Conclusion The incidence rate of HFMD fluctuated at a high level and EV71 ,CoxA16,and other enterovirus were prevalent alternatively as dominant pathogens among the reported HFMD incidents in Chifeng city between 2012 and 2015.