2012-2016年云南省大理州手足口病流行特征分析

Epidemiological Characteristics of Hand-foot-mouth Disease in Dali Prefecture of Yunnan Province From 2012 to 2016

目的分析2012-2016年云南省大理州手足口病流行特征,探讨其流行规律,为大理州手足口病的预防控制工作提供依据。方法采用描述性流行病学方法,对2012-2016年大理州中国疾病监测信息报告管理系统中手足口病资料进行分析。结果 2012-2016年大理州报告手足口病病例25 206例,其中重症病例32例,死亡1例,年平均报告发病率为140.77/10万,5年间手足口病均居于发病位次首位。2015年发病率最高(166.20/10万),2012年发病率最低(100.26/10万);报告发病覆盖12县(市)113个乡(镇)发病水平呈逐年上升趋势,呈双峰流行,第一高峰多出现于春夏交接季(5-8月),次高峰出现于夏秋交接季(10-11月);年均发病率宾川县最高(223.82/10万),漾濞县最低(65.17/10万);发病集中在5岁以下年龄组,其中1~2岁组发病专率最高(4 003.95/10万);以散居儿童发病为主(70.28%)。2 807例手足口病轻症病例经病原学检测,阳性检出率为36.67%,以Cox A16型和EV71型为主(64.26%,35.45%),优势毒株每2年一交替;重症率呈现高低交替。结论大理州手足口病呈逐年上升趋势,季节、地区、人群分布和优势毒株型特征明显,根据病原流行特征和病原学规律,适时对中心地区的重点场所、高危人群采取有效措施是防控关键。

Objective To elucidate the epidemiological characteristics of hand - foot -mouth disease （HFMD） in Dali prefecture from 2012 to 2016, to investigate the epidemic regularity, so as to provide scientific evidences for the HFMD prevention and control in Dali prefecture. Methods The surveillance data of HFMD in Dali prefecture from 2012 to 2016 was collected from the National Diseases Reporting Information System and was analyzed by epidemiological descriptive method. Results A total of 25 206 HFMD cases were reported in Dali prefecture, including 32 severe cases and 1 death case from 2012 to 2016. The annual incidence was 140.77/105. HFMD had been ranked first in the incidence of all reported diseases during these five years. Its incidence was lowest in 2012 and was highest in 2015, with the incidence of 100.26/ 105 and 166.20/105, respectively. HFMD cases were reported from 113 townships of 12 counties in Dali prefecture. The incidence had been increasing year by year and showing bimodal distribution. HFMD mostly occurred during the late spring and early summer （from May to August） , other would typically occurred in the late summer and fall （from October to November）. The highest annual incidence was in Binchuan county （223.82/105）, while the lowest annual incidence was in Yangbi county （65.17/105）. Most of the reported cases were children under 5 years old, the specific incidence rate was the highest scattered children （70. 28 % ） among children of 1 to 2 years old （4 003.95/105 ）. Most of the cases were Pathogen detection was performed in 2 807 mild HFMD cases with a positive rate of 36.67%, virus typing results were mainly Cox A16 and EV 71 （64.26% and 35.45% ）, the dominant strain alternated every two years, every year the severity rate of HFMD was alternating high and low. Conclusion The incidence rate of HMFD in Dali prefecture showed an ascending trend year by year. The characteristics of seasonal, regional and population distribution as well as the dominant strain were quite obvious. According to its epidemic characteristics and pathogenic characteristics, the most important strategy for HMFD prevention and control is taking timely and effective measures for key areas and high -risk groups in central region.