2009-2018年广西梧州市手足口病流行病学特征及病原学监测分析

Epidemiological characteristics and etiology surveillance of hand-foot-mouth disease in Wuzhou City,Guangxi from 2009 to 2018

目的分析2009-2018年梧州市手足口病流行特征及病原学特点,为制定手足口病防控策略提供依据。方法利用描述流行病学方法对2009-2018年梧州市中国疾病预防控制信息系统上报的手足口病病例和实验室检测结果进行统计分析。结果2009-2018年梧州市累计报告手足口病病例91064例,年均发病率为304.60/10万,总体呈现发病率上升的趋势,年发病率之间差异有统计学意义(χ^2=37102.658,P<0.001)。流行季节主要呈现双峰模式(4~7月、9~11月),发病主要为5岁以下儿童,共81739例(占89.76%),其中3岁以下59543例(占65.39%)。发病呈现明显的地区差异,各地年均发病率之间差异有统计学意义(χ^2=1454.983,P<0.001)。不同年份不同季节优势病原呈现动态变化,2012年前以EV 71为主,2013-2017年呈现EV 71、Cox A16和其他肠道病毒共同流行趋势,其他肠道病毒逐渐转换为优势菌株,2018年以Cox A16为主,其他肠道病毒次之。不同年份中EV 71、Cox A16和其他肠道病毒构成差异有统计学意义(χ^2=2268.679,P<0.001)。不同地区EV 71、Cox A16和其他肠道病毒构成差异有统计学意义(χ^2=434.770,P<0.001)。结论2009-2018年梧州市手足口病呈现明显的季节、人群以及地区分布规律。应进一步关注手足口病病原谱的变化,加大手足口病联合疫苗的研发力度,提高全人群的免疫能力,填补免疫空白。

Objective To analyze the epidemiological characteristics and etiological characteristics of hand-foot-mouth disease(HFMD)in Wuzhou City from 2009 to 2018 and to provide a basis for the development of prevention and control measures for HFMD.Methods The cases of hand-foot-mouth disease reported by Chinese Information Management System for Disease Prevention and Control and laboratory testing results in Wuzhou City from 2009 to 2018 were statistically analyzed by descriptive epidemiology method.Results From 2009 to 2018,a total of 91064 cases of HFMD were reported in Wuzhou,with an average annual incidence of 304.60/100000,showing an overall trend of rising incidence,with a statistically significant difference between the annual incidence(χ^2=37102.658,P<0.001).The popular season mainly presents double-peak mode(April to July,September to November).The major cases afflicted with HFMD were children less than five years old,with 81739 cases(89.76%),including 59543 cases(65.39%)under the age of 3 years old.The incidence showed significant regional differences,and the annual average incidence rate was statistically significant(χ^2=1454.983,P<0.001).The dominant pathogens showed dynamic changes in different years and seasons.EV 71 was the main pathogen before 2012,and EV 71,Cox A16 and other enteroviruses were in common epidemic trend from 2013 to 2017.Other enteroviruses gradually transformed into dominant strains.In 2018,Cox A16 was the main pathogen,followed by other enteroviruses.There were significant differences in EV 71,Cox A16 and other enteroviruses in different years(χ^2=2268.679,P<0.001)and in different regions(χ^2=434.770,P<0.001).Conclusion From 2009 to 2018,the HFMD in Wuzhou City showed obvious seasonal,populational and regional distribution.Further attention should be paid to the change of HFMD pathogen spectrum,and the research and development of HFMD combined vaccine should be intensified to improve the immune capacity of the whole population and fill the immune gap.