2011—2015年广东省基于主动监测的肠道病毒71型感染手足口病流行特征

Analysis on epidemiological characteristics of enterovirus 71 cases of hand-foot-mouth disease based on the active monitoring in Guangdong Province in 2011-2015

目的 了解广东省2011-2015年肠道病毒71型（EV-A71）感染手足口病流行特征。方法 通过＂广东省急性传染病监测信息平台系统＂收集2011年1月至2015年12月广东省8个哨点医院上报的感染EV-A71的手足口病普通病例监测数据，包括病例的年龄、发病日期和病原学数据等。通过＂中国疾病预防控制信息系统＂收集手足口病报告病例数及实验室确诊病例数资料，包括手足口病普通病例疫情数据、重症和死亡病例疫情数据，以及病例的年龄、发病日期和病原学数据等。结合两种来源的数据估算感染EV-A71手足口病发病率，描述其分布特征；采用χ2检验分别比较不同年龄组和不同月份间EV-A71感染手足口病阳性率及估算发病率的差异。结果 2011-2015年8个哨点医院共报告感染EV-A71的普通病例1 855例，其中，2014年最高（31.6%，605/1 916），2015年最低（6.8%，134/1 971）（χ^2=521.85，P〈0.001）。而通过疾病监测系统报告的2011-2015年广东省手足口病普通病例为1 772 516例，感染EV-A71的重症及死亡病例为1 902例；2011-2015年广东省手足口病重症及死亡病例中，感染EV-A71的构成比分别达72.6%（1 775/2 444）和97.0%（127/131）。各年龄组EV-A71感染手足口病年均估算发病率随年龄升高呈下降趋势（趋势χ^2=990 273.20，P〈0.001），1岁组最高，为1 697.67/10万，4岁组最低，为705.46/10万。各月份EV-A71感染手足口病年均估算发病率的差异有统计学意义（χ^2=401.23，P〈0.001），5月份最高，为15.51/10万，7月份最低，为9.42/10万。结论 广东省EV-A71感染手足口病在各年度流行水平不同，手足口病重症及死亡病例以EV-A71感染为主，1岁儿童是EV-A71感染手足口病高危人群，5月为EV-A71感染手足口病的高峰时间。

Objective To analyze the hand-foot-mouth disease （HFMD） enterovirus 71 （EV-A71） infection epidemic characteristics of Guangdong Province from 2011 to 2015.Methods We colleted data on common cases of hand-foot-mouth disease infected with EV-A71 reported from eight sentinel hospitals in Guangdong Province from January 2011 to December 2015, through the ＂Guangdong Province Acute Infectious Disease Surveillance Information Platform System＂ , including the age and incidence of cases. Time and etiological data, etc.We also collected data on the number of reported cases of HFMD disease and the number of laboratory-confirmed cases, through the ＂China Disease Prevention and Control Information System＂ , including data on common cases of HFMD disease, data on epidemics of severe cases and deaths, and the age, onset time, and pathogens of cases. Learning data, etc.The data from two sources were used to estimate the incidence of HFMD in EV-A71 and describe its distribution characteristics.Chi-square test was used to compare the positive rate of HF-A71 infection in hand-foot-mouth disease and the difference in estimated incidence among different age groups and months.Results Eight sentinel hospitals from 2011 to 2015 reported a total of 1 855 common cases of EV-A71 infection, of which the highest was in 2014 （31.6%, 605/1 916） and the lowest was in 2015 （6.8%, 134/1 971） （χ^2=521.85, P〈0.001）.According to the Disease Surveillance Reporting Information System, 1 772 516 cases of HFMD disease were reported from 2011 to 2015 in Guangdong Province, and 1 902 cases of severe and fatal cases of EV-A71 infection.The composition ratio of EV-A71 infected was 72.6% （1 775/2 444） and 97.0% （127/131） of severe HFMD disease in Guangdong province during 2011-2015.The average annual incidence of HF-A71 infection in all age groups showed a decreasing trend with age （χ^2trend=990 273.20, P〈0.001）, and it was the highest in the 1-year-old group, which was 1 697.67/100 000, and the lowest in the 4-year-old group, which was 705.46/100 000. The difference of monthly average incidence of EV-A71 infection in HF-A71 in each month was statistically significant （χ^2=401.23, P〈0.001）, the highest in May at 15.51 per 100 000, and the lowest in July at 9.42 per 100 000.Conclusion EV-A71 infection rate of ordinary HFMD varies in different years. The most severe and death cases of HFMD were EV-A71 infected. 1 year old children were the high-risk group of infected with EV-A71 HFMD. April was the epidemic months of EV-A71 HFMD infection.