广东省2012—2016年柯萨奇病毒A组16型感染手足口病病例流行特征分析

Epidemiological characteristics of Coxsackie virus AI6 caused hand foot and mouth disease cases in Guangdong province, 2012-2016

目的了解2012-2016年广东省柯萨奇病毒A组16型（CoxA16）感染手足口病病例流行特征。方法在广东省8个城市共选取8家哨点医院开展手足口病普通病例CoxA16感染监测，结合手足口病个案及暴发数据，估算CoxA16感染手足口病发病情况并分析人群和时间分布特征。结果①广东省CoxA16感染手足口病估算发病率以2014年（113．0／10万）最高，其次为2016年（86．4／10万）、2012年（79．1／10万）；2015年（29．0／10万）和2013年（28．8／10万）较低。②暴发以CoxA16感染（54．6％，89／163）为主，高流行年份年均暴发数（28起）是低流行年份（2．5起）的11．2倍。③估算发病率随年龄升高呈下降趋势（趋势Ⅳ。=853905．63，P〈0．01），高发年龄组依次为1～（1449．2／10万）、3～（1097．0／10万）、2～（1083．5／10万）、4。（687．8／10万）和0～岁（604．9／10万）；随月龄增加呈上升趋势（趋势Х^2=5541．77，（P〈0．01），高发月龄依次是11～（2105．1／10万）、10～（1448．6／10万）、9～（938．3／10万）、8～（703．3／10万）和6～月龄（664．6／10万）。④高发月份是5月（143．9／10万）和6月（131．5／10万）。结论2012—2016年广东省CoxA16感染手足口病在各年份流行强度不同；CoxA16感染水平高时，暴发疫情增多，主要发生在托幼机构，5—6月常见，0～4岁儿童是CoxA16感染手足口病高危人群，6～11月龄为高发月龄。

Objective To analyze the epidemiological characteristics of hand foot and mouth disease （HFMD） cases caused by Coxsackie virus A16 （Cox A16） in Guangdong province from 2012 to 2016. Methods The data of mild HFMD cases caused by Cox A16 were collected from 8 sentinel hospitals in 8 prefecture-level cities in Guangdong to estimate Cox A16 infection status and its population and time distribution characteristics. Results （1） The highest estimated incidence of Cox A16 infection was in 2014 （113.0/100 000）, followed by 2016 （86.4/100 000） and 2012 （79.1/100 000）, while the estimated incidence was lower in 2015 （29.0/100 000） and 2013 （28.8/100 000）. （2） Cox A16 was confirmed to be the predominant pathogen causing HFMD outbreaks （54.6%, 89/163）. The number of outbreaks in the year with high incidence （28 outbreaks） was 11.2 times higher than that in the year with low incidence （2.5 outbreaks）. （3） Across all age groups, the annual estimated incidence of Cox A16 infection decreased with age （trendx2=853 905.63, P〈0.01）. The incidence was highest in age group 1 year （1 449.2/100 000）, followed by that in age group 3 years （1 097.0/100 000）, in age group 2 years （1 083.5/100 000）, in age group 4 years （687.8/100 000） and in age group 0 year （604.9/100 000）. Among the age groups 〈12 months, the estimated incidence increased with age （trend Х^2=5 541.77, P〈0.01）, which was highest in age group ll-months （2 105.1/ 100 000）, followed by that in age groups 10-months （1 448.6/100 000）, 9-months （938.3/100 000）, 8-months （703.3/100 000） and 6-months （664.6/100 000）. （4） The annual incidence peak was during May （143.9/100 000）-June （131.5/100 000）. Conclusion The prevalence of Cox A16 infection differed with year in Guangdong during 2012-2016. When the incidence of Cox A16 infection was high, more outbreaks occurred. The prevalence occurred mainly in nurseries and kindergartens from May to June each year. Children aged 0-4 years were the high risk group for Cox A 16 infection, children aged 6-11 months were at high risk for Cox A 16 infection.