阜阳市2008～2016年手足口病流行病学及病原学特征分析

Epidemiological and etiological characteristics of hand-foot-mouth disease in Fuyang city from 2008 to 2016

目的分析手足口病(HFMD)的流行病学特征及病原谱变化,为减少重症和死亡病例所采取的控制措施提供科学依据。方法采用描述流行病学方法对阜阳市2008～2016年HFMD监测数据进行分析,用Real-time PCR法对HFMD标本进行肠道病毒核酸检测和分型鉴定。结果2008～2016年阜阳市累计报告HFMD 184 133例,重症1 504例,死亡40例;发病呈双峰分布特点,4～7月为流行主高峰,10～12月为小高峰;年均发病率排在前3位的是颍州区、颍泉区和颍东区;发病以散居儿童为主,5岁以下儿童占94. 20%,男女性别比为1. 67∶1,比例呈逐年下降趋势;实验室诊断病例中EV-A71占50. 94%,CV-A16占9. 25%,其他肠道病毒占39. 81%;不同年份优势病原呈现动态变化,其他肠道病毒取代EV-A71成为近两年的优势病原;当EVA71为优势病原时,重症和死亡病例的比重增加,EV-A71仍是导致重症和死亡病例的绝对优势病原。结论阜阳市HFMD发病呈现明显的季节、人群和地区分布,病原谱不断变化。应加强实验室检测,根据病原构成动态变化对重点县区和人群采取针对性防控措施。

Objective To study the epidemiological and etiological characteristics of hand-foot-mouth disease,to provide scientific evidence for prevention and control measures in reducing the severe and death cases.Methods The case data of HFMD in Fuyang city from 2008 to 2016 were collected from the Chinese National Notifiable Infectious Disease Reporting System.Real-time PCR was used to detect and classify HFMD samples.Results A total of 184 133 cases of HFMD cases were reported in Fuyang city from 2008 to 2016,including 1 504 severe cases and 40 deaths.The main peak of the epidemic occurred in April to July and a prevalent peak in October to December.The top three annual rates were Yingzhou district,Yingquan district and Yingdong district.Scattered children had the highest incidence,children under 5 years of age accounted for 94.20%.The male-female sex ratio was 1.67∶1,incidence of male and female showed a declining trend year by year.EV-A71 accounted for 50.94%,CV-A16 accounted for 9.25% and other enteroviruses accounted for 39.81% in laboratory diagnosis dynamic.Changes were presented between different years,other enteroviruses had replaced EV-A71 as the dominant pathogen in the past two years.When EV-A71 was the predominant pathogen,the proportion of severe cases and death cases increased.Conclusion This study suggests that the incidence of HFMD in Fuyang city is obviously seasonal,population and regional distribution,the spectrum of pathogens is constantly changing.The laboratory tests should be strengthened,targeted prevention and control measures should be taken in key counties and populations according to the dynamic change of the pathogen.