陕西省2009-2018年手足口病流行特征及动态变化分析

Dynamics and epidemiological characteristics of hand,foot and mouth disease in Shaanxi province,2009-2018

目的了解陕西省手足口病流行特征及动态变化特点,为科学防控手足口病提供依据。方法数据来源于中国疾病预防控制信息系统2009-2018年陕西省手足口病报告病例,采用动态几何数列平均法和圆形分布法对其流行特征进行描述和分析。结果2009-2018年陕西省手足口病年均发病率为140.04/10万,发病率呈上升趋势,死亡率和病死率均呈波动性下降。发病率最高的依次为1~岁组(3 494.24/10万)、2~岁组(2 734.79/10万)和3~岁组(2 608.58/10万),报告死亡率最高的依次为1~岁组(1.42/10万)、2~岁组(0.77/10万)和0~岁组(0.53/10万)。发病率增长速度最快的是1~岁组和0~岁组,平均增长速度分别是17.89%和17.05%。年均报告发病率位居前3位的分别是西安市(251.34/10万)、渭南市(161.21/10万)和咸阳市(123.73/10万),均位于关中平原地区。10个地级市的发病率平均增长速度均>0;多个地级市的重症比例呈不同程度下降趋势。圆形分布法推测的发病高峰时间为每年的4月10-11日,高发月份为每年的4-7月。2018年的肠道病毒71型的构成比仅为26.47%(1 303/4 922)。2014-2018年柯萨奇病毒A组16型的构成比在20.06%(753/3 753)~23.08%(855/3 705)之间。其他肠道病毒构成比从2009年的6.09%(14/230)增加到2018年的51.91%(2 555/4 922)。结论2009-2018年陕西省手足口病的重点人群为<3岁幼儿,总体发病率呈上升趋势,而死亡率、病死率呈下降趋势,大部分地区的重症比例呈下降趋势。病原构成也随时间的发展不断变化。

Objective To understand the dynamics and epidemiological characteristics of hand,foot and mouth disease(HFMD)in Shaanxi province during 2009-2018 and provide evidence for prevention and control of HFMD.Methods Information on HFMD was collected from the Chinese Disease Prevention and Control Information System in Shaanxi Province during 2009-2018 and was analyzed by descriptive,dynamic geometric series averaging and circular distribution methods.Results The annual average incidence rate of HFMD was 140.04/100 000 in Shaanxi province during 2009-2018.The highest incidence rates were seen in age groups as 1-year olds(3 494.24/100 000),2-year olds(2 734.79/100 000)and 3-year olds(2 608.58/100 000).The highest reported mortality rates appeared in:1-year olds as 1.42/100 000,2-year olds as 0.77/100 000)and 0-year olds(0.53/100 000).The incidence rate increased most rapidly in the 1-year olds and the 0-year olds groups.The top three incidence rates were reported in Xi’an(251.34/100 000),Weinan(161.21/100 000)and Xianyang(123.73/100 000)cities in Guanzhong area of Shaanxi province.In the whole province,incidence rate was on the rise,and the average increases of incidence rates were all greater than zero in these cities.The proportion of severe cases in most cities somehow declined.Results from the circular distribution method estimated that the peak incidence would appear in April 10-11 each year,and the high incidence season was from April to July.In 2018,the composition of enterviruses(EV)71 was 26.47%(1 303/4 922).In 2014 to 2018,the proportion of Coxsackie virus A16(Cox A16)was between 20.06%(753/3 753)and 23.08%(855/3 705).The proportions of other EVs increased from 6.09%(14/230)to 51.91%(2 555/4 922)during 2009-2018.Conclusions The overall incidence rate of HFMD was increasing,with high risk population appeared in children under 3 year olds,in Shaanxi province during 2009-2018.However,both mortality and fatality rates were declining,with severe cases also showing a downward trend in most of the areas.Composition of pathogens was changing over time.