2009-2018年洋县手足口病流行特征分析

Epidemiological Characteristics of Hand-foot-and-mouth Disease in Yang County From 2009 to 2018

目的分析洋县手足口病流行特征,从而制订防控对策,通过采取有效措施,降低发病率。方法采用描述性流行病学方法,对2009-2018年洋县传染病疫情报告的手足口病病例进行分析。结果2009-2018年共报告手足口病2713例,其中,重症病例20例,年平均发病率60.66/10万,重症百分比为0.74%。5~7月为发病高峰,报告病例占总病例数的61.04%;洋县18个镇(办)均有病例报告,县城区域年均发病率(79.93/10万)与平川区域发病率(57.00/10万)、山岭区域发病率(56.14/10万)差异有统计学意义(χ^2=56.20,P<0.01);报告病例中男女性别之比为1.75∶1,发病年龄以0~5岁为主,尤其是1~3岁组发病率较高,1~2岁组发病率高于2~3岁组和3~4岁组(χ^2=284.39,P<0.01)。职业以散居儿童及幼托儿童为主,分别占总病例数的77.29%、16.88%,两者合计(94.18%)。72例确诊普通病例病原型别为EV 71型2例、CoxA16型20例、其他肠道病毒50例,依次占确诊普通病例的2.78%、27.78%和69.44%;20例确诊重症病例的病原型别均为EV 71型;重症病例EV 71型阳性例数与普通病例EV 71型阳性例数之比为10∶1(20/2)。结论2009-2018年洋县手足口病发病有明显的季节、地区和人群分布特征,今后防控重点应以0~5岁散居儿童和幼托机构儿童为主,采取综合性防控措施;对适龄儿童及早接种EV 71型手足口病疫苗,以预防EV71型重症病例的发生。

Objective To analyze the epidemic characteristics of hand-foot-and-mouth diseases(HFMD)in Yang County so as to formulate prevention and control measures and take effective measures to reduce the incidence rate.Methods Descriptive epidemiological method was used to analyze the HFMD cases reported in Yang County from 2009 to 2018.Results From 2009 to 2018,a total of 2713 cases were reported,with an average annual incidence of 60.66/105.20 severe cases were reported,and the percentage of severe cases was 0.74%.The incidence peak was from May to July,and 61.04%of the total number of cases were reported.All 18 towns have cases reported in Yang County.There were significant differences(χ~2=56.20,P<0.01)among the average annual incidence rate of the county(79.93/105),and the hirakawa region(57.00/105)and the mountain region(56.14/105).The sex ratio among the reported cases was 1.75∶1.Most reported cases aged 0-5 years,particularly the 1-3 year-old group.The incidence rate of 1-2 year-old group was higher than that of 2-3 year-old group and 3-4 year-old group(χ~2=284.39,P<0.01).Scattered and nursery children accounted for77.29%and 16.88%of the total cases,respectively.The pathogenic types of 72 common cases were EV71(2 cases),CoxA16(20 cases)and other enteroviruses(50 cases),which accounted for 2.78%,27.78%and 69.44%of the common cases respectively.The pathogenic types of 20 severe cases are all EV71.The ratio of EV71 severe positive cases to EV71 common positive cases was 10∶1(20/2).Conclusion The incidence of HFMD has obvious seasonal,regional and population distribution characteristics in Yang county from 2009 to 2018.In the future,the focus of prevention and control should be on scattered children aged 0-5 years and children in kindergartens,and comprehensive prevention and control measures should be taken.EV71 HFMD vaccines should be vaccinated early to children of appropriate age to prevent severe cases of EV71.