2013-2018年郴州市手足口病流行病学特征及EV71疫苗接种效果分析

Incidence of hand,foot and mouth disease and effect of EV71 vaccine vaccination in Chenzhou city of Hunan province,2013-2018

目的分析2013-2018年郴州市手足口病流行特征及EV71疫苗接种效果,为控制手足口病的流行提供科学依据。方法收集2013-2018年郴州市手足口病发病监测和EV71疫苗接种资料,EV-A71、CV-A16和其他HEV病原检测采用实时荧光定量反转录聚合酶链反应。结果中计数资料的统计分析用χ^2检验,P<0.05为差异有统计学意义。结果2013-2018年郴州市手足口病累计报告发病数55026例,其中重症病例91例(死亡病例12例);年均报告发病率为195.5/10万(154.5/10万~256.9/10万)。发病具有明显的季节性,呈双高峰分布,主要集中在5-6月,9-11月再次小幅度上升;3岁及以下儿童病例占86.8%;男性多于女性,为1.7:1。地区分布以安仁、临武和北湖等县(区)为主,桂东县最低。手足口病病例、重症病例、聚集性疫情的病原体型别构成多样。郴州市2016-2018年共131075人接种了EV71疫苗,接种人群接种EV71疫苗前后手足口病重症病例的发生率有统计学意义。结论郴州市手足口病疫情依然严重,3岁及以下儿童(特别是男性)是重点防控人群。疾病病原谱复杂。EV71疫苗的接种能有效防控同类型病毒感染发病和降低重症病例发生。

Objective To analyze the epidemic characteristics of hand-foot-mouth disease(HFMD)and the effect of enterovirus A71(EV-A71)vaccine vaccination in Chenzhou city from 2013 to 2018 and to provide evidences for the control of HFMD.Methods We collected surveillance data on HFMD incidence,detection of pathogens including EV-A71,coxsackievirus A16(CV-A16)and other human enterovirus(HEV),and vaccination of EV71 vaccine in Chenzhou city from2013 to 2018.The data on Detection of EV-A71,and other HEV pathogens were detected with Real-time fluorescence quantitative reverse transcription polymerase chain reaction(real time RT-PCR)was adopted in detections of nucleic acid of EV-A71,CV-A16 and other HEV in sampled specimens.Chi-square test was used in statistical analysis.Results During the period in the city,totally 55026 HFMD cases(including 91 severe cases and 12 deaths)were reported and the reported average annual incidence rate was 195.5/100000(ranging from 154.5 to 256.9 per 100000).Obvious seasonality and the two epidemic peaks from May to June and from September to November in a year were observed in HFMD incidences.Of the reported cases,86.8% were children under 3 years old and the male to female ratio of the reported cases was 1.7:1.The reported HFHD incidence rate varied among the 11 counties/districts in the city.The distribution of detected pathogenic viruses differed by time and disease severity of patients.From 2016 to 2018,a total of 131075 children were inoculated with EV71 vaccine.Significantly lower incidence rate of severe HFMD was observed after the implementation of EV71 vaccine vaccination.Conclusion Hand-foot-mouth disease caused by various enteroviruses is still prevalent and in Chenzhou city;the children under 3 years old is the key population in the control of the disease;EV71 vaccine vaccination could reduce the incidence of severe hand-foot-mouth disease.