2009—2017年浙江省手足口病流行病学特征及病原学监测分析

Epidemiologic characteristics and pathogen surveillance of hand.foot and mouth disease in Zhejiang province.2009-2017

目的分析浙江省2009-2017年手足口病流行病学特征和病原学监测结果,为手足口病的防控提供科学依据。方法运用描述流行病学方法分析手足口病在浙江省的三间分布特征,运用荧光定量逆转录聚合酶链反应的方法对标本进行检测。结果2009-2017年,浙江省共累计报告手足口病病例1108093例,年平均发病率226.24/10万。浙江省手足口病呈周期性流行,2010、2012,2014和2016年的发病水平高于其他年份。4~7月份呈现发病主高峰.秋冬呈现次高峰。温州、台州和宁波等地市的手足口病发病水平高于其他地市。1~3岁儿童发病占65.67%,散居儿童占69.27%。病原学监测数据显示轻症手足口病病例肠道病毒A组71型(Enterovirus A71,EV-A71)所占比例呈下降趋势,非EV-A71、非柯萨奇病毒A组16型(coxsackievirus A16,CV-A16)的其他肠道病毒明显升高,重症和死亡病例仍以EV-A71为主(56.3%)。结论浙江省手足口病的地区、季节和人群特征明显,近年来轻症病例以非EV-A71、非CV-A16的其他肠道病毒为主,重症和死亡病例以EVA71病原为主。持续的病原学监测有助于掌握优势病原型别,从而为防控提供依据。

Objective To evaluate the epidemiologic characteristics of hand, foot and mouth disease in Zhejiang province between 2009 and 2017, so that scientific evidence could be provided for prevention and control of hand, foot and mouth disease. Methods Spatial, temporal and population distribution of HFMD was analyzed. Real-time reverse transcription polymerase cain reaction was used to test Enterovirus A71 and Coxsackievirus A16 in samples. Results Between 2009 and 2017, 1 108 093 HFMD cases were reported in Zhejiang with the prevalence of 226. 24/100000;2010,2012,2014 and 2016 had a higher prevalence than other years. Prevalence of HFMD peaked in April-July and September-October. Wenzhou , Taizhou and Ningbo had a higher prevalence than other cities. In total, 69. 27% cases were children who were not enrolled in nursery school, and 65. 67% were 1-3 years old. Pathogen surveillance showed that EV-A71 decreased in mild cases, whereas other enterovirus increased. However EV-A71 was still predominant in severe and fatal cases (56.0%). Conclusions Temporal and spatial distribution of HFMD is characteristic in Zhejiang province. EV-A71 predominated in severe cases and fatal cases, while other enterovirus (non-EV-A71, non CV-A16) were the main pathogen for mild cases.