深圳龙岗区2013～2017年手足口病流行特征分析

Epidemiological characteristics of hand,foot and mouth disease in Longgang district of Shenzhen,2013-2017

目的分析2013~2017年深圳市龙岗区手足口病(HFMD)流行病学特征,探讨手足口病流行规律。方法收集国家"传染病报告信息管理系统"和"深圳市传染病暴发疫情信息管理系统"中的HFMD发病数和暴发疫情数,采用描述性流行病学方法,分析HFMD分布特征。应用real-time RT-PCR技术,检测肠道病毒71型(Enterovirus 71,EV 71)和柯萨奇病毒A16群毒株(Coxsackie virus,Cox A16),对病原学特征进行分析。结果 2013~2017年共报告HFMD 77 328例,其中重症病例33例,占0.043%;死亡4例,普通病例的病死率为5.17/10万;HFMD平均发病率为743.89/10万,年均死亡率为0.038/10万,近三年发病水平有所下降。HFMD每年各月均有病例发生,单峰型以5~9月发病数最多,双峰型以4~6月和9~10月病例数较多。全区所有街道办事处(街道)均有病例发生,以人口数较多的布吉、龙岗、龙城发病数较多。普通病例中,5岁以下儿童发病数占总病例的94.44%;散居儿童占76.81%,高于托幼机构儿童(19.49%),男性与女性发病数之比为1.53∶1。2013~2017年共采集样本3 387份,肠道病毒核酸阳性1 912份,总阳性率为56.45%;其中EV 71和Cox A16的阳性率分别为15.12%和20.25%,其他肠道病毒阳性率为21.08%。2013~2017年共报告暴发疫情80起,覆盖所有街道,发生在4~10月占总起数的90%;其中Cox A16暴发32起,EV71暴发19起,其他肠道病毒感染16起。结论深圳龙岗区为HFMD高度流行区,发病呈夏季单峰或双峰型,5岁及以下散居儿童多于托幼机构儿童,病原体主要为EV71和Cox A16。

Objective To analyze the epidemiological characteristics of hand,foot and mouth disease（HFMD） in Longgang district of Shenzhen city from 2013 to 2017,and discover the epidemiologic features of HFMD.Methods The HFMD data from China ＇s National Surveillance and Shenzhen Outbreak System for Communicable Diseases from 2013 to2017 were collected,and the epidemiologic distribution features of HFMD were described.The EV71,Cox A16 and other Enterovirus were tested by the techniques of the real-time RT-PCR.Results A total of 77 328 mild cases of HFMD were reported in Longgang district from 2013 to 2017,including 33 severe cases with the proportion of 0.043% and 4 fatal cases with fatality rate of 5.17 per 100 000.The annual incidence and mortality rate of HFMD were 743.89 per 100 000 and 0.038 per 100 000.The incidence rates were decreased slightly during the last 3 years.HFMD cases were found in every month,and the numbers of cases from May to September was mostly found as the peak for single-peak pattern,while the number of cases from April to June and September to October were two peaks for two-peak patterns.Although all eight subdistrict offices under the jurisdiction of Longgang district had reported cases in the past five years,more cases（60.04%） were reported in Buji,Longgang and longcheng offices.Among the mild cases,children younger than 5 years of age were highly vulnerable（91.39%） to HFMD,home children had higher risk（76.81%） to develop the HFMD than nursery children（19.49%）,and the ratio of boys to girls was1.53∶1.A total of 3 387 specimens were tested and 1 912 positive specimens with the rate of 56.45% were found,including EV71（with rate 15.12%）,Cox A16（with rate 20.20%） and other Enterovirus（with rate 21.08%）.The 80 outbreaks covered all 8 offices were reported during the study period.Outbreaks from April to October accounted for 90% of the total number of outbreaks,including 32 Cox A16 outbreaks,19 EV71 outbreaks and 16 other enterovirus infections.Conclusion Longgang district in Shenzhen was a high epidemic area of HFMD.A HFMD seasonal epidemic feature appeared with a combination of single-peak and two-peak patterns.Children younger than 5 years of age were the main infected population,and the number of scattered children were much higher than that of nursery children.EV71 and Cox A16 were still the main two pathogens.