2008—2016年锦州市手足口病流行病学分析

Epidemiological analysis of hand, foot, and mouth disease in Jinzhou from 2008 to 2016

目的了解锦州市2008-2016年手足口病流行特征，为手足口病防控工作提供参考依据。方法通过中国疾病预防控制信息系统收集锦州市2008-2016年手足口病疫情数据，内容包括基本信息、发病概况、病例报告时间和地点等，对采集的病例咽拭子或粪便样本利用实时荧光PCR法进行肠道病毒及分型检测。采用描述性流行病学方法进行分析，率的比较采用χ^2检验。结果2008i2016年锦州市共报告手足口病9154例，年均发病率为32．33／10万，发病数和发病率总体均呈下降趋势；城区病例数（6329例）高于农村地区（2825例），发病高峰集中在6-9月，占总病例数的77．75％；男性发病率（38．02／10万）高于女性（26．58／10万）（χ^2=263．32，P〈0．01）；各年龄组间发病率差异有统计学意义（χ^2=185429．60，P〈0．01），其中3岁年龄组发病率最高（1037．87／10万），10岁以上年龄组最低（0．68／10万）。实验室确诊手足口病病例1077例，占病例总数的11．77％，其中柯萨奇A组16型占36．58％，肠道病毒71型占28．32％，其他肠道病毒阳性占35．10％。结论锦州市手足口病发病率总体呈现下降趋势，病原体以柯萨奇A组16型为主；具有明显的季节性，6-9月为发病高峰；男性、低龄儿童是手足口病的高危人群。

Objective To investigate the epidemiological characteristics of hand, foot, and mouth disease （HFMD） in Jinzhou from 2008 to 2016, so as to provide reference for the prevention and control measure of this disease. Methods Data on the epidemic of HFMD in Jinzhou from 2008 to 2016 were collected through the China Information System for Disease Control and Prevention, including the demographic characteristics, general situation of the disease, reporting case time and districts. Throat swabs or feces were collected for identification and typing by real time fluorescence PCR method. A descriptive epidemiological method was used to analyze the data and the rates were compared by chi-square test. Results From 2008 to 2016, 9 154 cases of HFMD were reported in Jinzhou City. The average annual incidence was 32.33/100 000, and overall case numbers and incidences were generally declining. Numbers of cases in urban area （6 329） was higher than that in rural area （2 825）. The incidence peak was observed in June-September, accounting for 77.75% of all the cases. The incidence of male （38.02/100 000） was higher than that of female （26.58/100 000） （x2=263.32, P〈0.01）. There was significant difference in the incidence of disease among all age groups （x2=185 429.60, P〈0.01）. The highest incidence rate was found in the age group of 3 years old （1 037.87/100 000）, while the lowest was the age group over 10 years of age （0.68/100 000）. A total of 1 077 cases of laboratory diagnosis of HFMD were reported, accounting for 11.77% of the total number of cases. For the laboratory diagnosed cases, the Cox A16 accounts for 36.58%, EV71 positive accounted for 28.32%, and other enterovirus accounted for 35.10%. Conclusions The incidence of HFMD in Jinzhou was deceasing in trend. The main pathogen is Cox A16. It has obvious seasonality and theincidence peak was from June to September. Male and young children are at high risk of the disease.