2010—2016年河北省手足口病重症和死亡病例流行特征分析

Analysis of the epidemiological characteristics of severe and deceased cases of hand, foot and mouth disease in Hebei province between 2010 and 2016

目的了解河北省手足口病（hand, foot and mouth disease，HFMD）重症和死亡病例的流行特征，为HFMD防控提供参考依据。 方法对2010—2016年河北省HFMD重症和死亡病例三间分布和病原体分布特点进行分析。结果2010—2016年河北省累计报告HFMD重症病例3 803例，死亡162例，年均重症比例为0.75%。男性与女性重症HFMD发病率有差异，且差异具有统计学意义（χ2＝239.37，P＝0.000）；以散居儿童为主；6月龄以内的婴儿重症比例最高，1～岁组的幼儿重症HFMD发病率最高。邢台、廊坊和衡水三市的重症HFMD发病率及重症比例均位居前三；7年来报告重症病例数上下浮动，但总体呈下降趋势。重症病例和死亡病例中EV-A71的构成比分别为79.25%和92. 66%。结论河北省重症HFMD疫情呈下降趋势，EV-A71仍是引起重症和死亡的主要病原，应重点加强对低龄（〈2岁）儿童的防护救治措施。

ObjectiveTo analyze the epidemiological characteristics of severe and deceased cases of hand, foot and mouth disease （HFMD） in Hebei province, so as to provide reference for prevention and control of the disease.MethodsSevere and deceased HFMD cases reported from the National Disease Surveillance Information Management System and the laboratory testing result in Hebei province from 2010 to 2016 were analyzed. Descriptive epidemiological method involving the distribution of population, area, time and pathogeny were used for the analysis.ResultsFrom 2010 to 2016, 3 803 severe HFMD cases and 162 deceased cases were reported in Hebei province, and the ratio of severe cases among all HFMD patients was 0.75%. A chi-square test showed that the incidence of severe HFMD between males and females was significantly different （χ2=239.37, P〈0.001）, and scattered children were the main patient. Infants less than six months of age had the highest ratio of severe HFMD cases, the group of one-year-old and younger children had the highest proportion of severe HFMD cases. The severe ratio and severe incidence of Xingtai, Langfang and Hengshui were the top three prefectures having the highest proportions of severe cases. The number of severe cases fluctuated over the past 7years, but showed a downward trend. The constituent ratios of EV-A71 in severe cases and deaths were 79.25% and 92.66%, respectively.ConclusionsSevere HFMD epidemics showed a declining trend in Hebei province. EV-A71 is still the main pathogen of both severe and fatal cases. It is necessary to strengthen the prophylactic and therapeutic measures for the young children （〈 2 years）.