2010-2018年洛阳市涧西区手足口病流行特征分析

Epidemiological characteristics of hand-foot-mouth disease in Jianxi District of Luoyang in 2010-2018

目的了解洛阳市涧西区2010-2018年手足口病流行特征,为制订预防控制措施提供科学依据。方法收集中国疾病预防控制信息系统传染病管理系统中洛阳市涧西区2010-2018年报告的手足口病病例,采用描述流行病学进行分析。结果2010-2018年全区共报告手足口病病例9784例,年均发病率179.34/10万,每隔2~4年一个流行高峰;其中重症病例512例,占发病总数的5.23%,死亡1例。4~7月为高发季节,发病7176例,占病例总数的73.34%;发病主要以5岁以下儿童为主,1~3岁为高发年龄,发病7167例,占发病总数的73.25%;各年龄男性发病均高于女性,男女性别比为1.3∶1;发病职业以散居儿童为主,其次为幼托儿童,两者合计占发病总数的96.25%。2010年以来,手足口病病原构成发生变化,EV 71呈波动下降趋势(χ^2=63.68,P<0.01),其他肠道病毒波动上升,Cox A16波动幅度较小,重症病例病原构成与普通病例基本一致(χ^2=1.33,P>0.05)。结论洛阳市涧西区为手足口病高发地区,发病有明显的季节性;散居、幼托儿童为预防和控制手足口病的重点人群;提高手足口病的监测敏感性,采取针对性的综合措施是防控手足口病的关键。

Objective To understand the epidemiological characteristics of hand-foot-mouth disease(HFMD)in Jianxi District of Luoyang from 2010 to 2018,and to provide a scientific basis for formulating preventive and control measures.Methods Data of HFMD cases reported in Jianxi District of Luoyang were selected from the infectious diseases management system of China information system for diseases control and prevention from 2010 to 2018,and further analyzed by descriptive epidemiological method.Results From 2010 to 2018,9784 HFMD cases were reported in the whole district,with an average annual incidence rate of 179.34/100000 and an epidemic peak every 2~4 years.There were 512 severe cases which accounted for 5.23%of the total cases and one death.April to July had a high incidence of disease,and there were 7176(73.34%)HFMD cases in this period.The disease was mainly concentrated on children aged younger than 5 years old.The age of 1~3 was where the disease was likely to develop,which involved 7167 cases accounting for 73.25%of all cases.The incidence rate of males was higher than that of females in all age groups,and the ratio of males to females was 1.3∶1.The most popular occupation of HFMD cases were diaspora children followed by kindergarten children,and the combined HFMD cases of two parties above accounted for 96.25%of the total cases.The pathogens of HFMD had changed since 2010.EV 71 was in a fluctuant downward trend(χ^2=63.68,P<0.01),other enteroviruses were in a fluctuant upward trend and Cox A16 fluctuated slightly.The pathogenic composition of severe cases was basically the same as that of common cases(χ^2=1.33,P>0.05).Conclusion Jianxi District of Luoyang was the high-prevalence area of HFMD,and the incidence had obvious seasonal characteristics.The focus of prevention and control of HFMD should be put on the scattered and kindergarten children.The key to prevention and control of HFMD are to improve the sensitivity of HFMD surveillance and adopt targeted and comprehensive measures.