2012-2017年河北省手足口病流行及病原构成特征分析

Epidemiologic and etiological characteristics of hand, foot and mouth disease in Hebei province of China from 2012 to 2017

目的分析2012—2017年河北省手足口病(hand,foot and mouth disease,HFMD)的流行特征及病原构成特征,为HFMD的防控提供科学依据。方法收集2012-2017年河北省HFMD病例资料和实验室检测结果,进行描述流行病学分析。结果2012-2017年河北省累计报告HFMD病例382984例,重症病例1591例,死亡63例,年均发病率86.80/10万,年均病死率16.45/10万。HFMD夏季疫情高峰期向后推迟,每年的峰值呈后延态势:2012年为5月,2013-2015年为6月,2016-2017年为7月。HFMD发病率较高地区为廊坊市(129.17/10万)、保定市(128.84/10万)、沧州市(127.91/10万)以及承德市(105.66/10万)。发病人群以散居儿童为主,占76.59%(293316/382984);2012-2017年散居儿童构成比呈隔年高发、总体下降趋势,而幼托儿童构成比呈隔年高发、总体上升趋势。HFMD病死率与肠道病毒71型(human enterovirus 71,EV-A71)的构成比存在正相关关系(r=0.943,P=0.005),其他肠道病毒所占比例最高,且构成比呈总体上升的趋势。结论河北省HFMD有着明显高发的地区,亦存在着不同程度散在流行的区域,非EV-A71非CV-A16的其他肠道病毒构成比呈总体上升趋势,建议重点防控HFMD的高发地区及强化非EV-A71非CV-A16的其他肠道病原谱的监测。

Objective To analyze the epidemiological and etiological characteristics of hand,foot and mouth disease(HFMD)in Hebei province of China from 2012 to 2017.Methods Data of HFMD and laboratory results in Hebei province from 2012 to 2017 were collected and analyzed by a descriptive epidemiological method.Results From 2012 to 2017,a total of 382984 HFMD cases including 1591 severe cases and 63 deaths were reported in Hebei province of China,with an average annual incidence of 86.80/100000 and an average annual case fatality rate of 16.45/100000.The summer epidemic peak of HFMD was postponed and the peak of every year by month was delayed:May of 2012,June of 2013-2015 and July of 2016—2017.The areas of higher incidences were Langfang city(129.17/100000),Baoding city(128.84/100000),Cangzhou city(127.91/100000)and Chengde city(105.66/100000).The majority cases were scattered children that accounted for 76.59%(293316/382984).From 2012 to 2017,the overall trend o£scattered children was downward,while the overall trend of preschool cases was upward.There was a positive correlation between the case fatality rate of HFMD and the composition ratio of human enterovirus 71(EV-A71)(correlation coefficient r=0.943,P=0.005).The proportion of other enteroviruses were detected to be highest and also on the rise as a whole.Conclusions The HFMD of Hebei province not only showed a clearly high incidence by areas but also scattered w让h different degrees and the proportion of other enteroviruses other than EV-A71 and CV-A16 demonstrated an overall rising trend.