株洲市2009-2018年确诊手足口病流行病学分析

Epidemiological analysis of confirmed hand,foot and mouth disease(HFMD)in Zhuzhou City from 2009 to 2018

目的分析株洲市2009—2018年确诊手足口病的流行病学特征及主要病毒类型,为全市手足口病防控提供参考依据。方法以中国疾病预防控制信息系统中实验室确诊的手足口病病例为数据资料,用描述流行病学方法分析其分布特征,采用卡方检验比较每年柯萨奇病毒A组16型(Cox A16)、其他肠道病毒和肠道病毒71型(EV71)手足口病报告发病率的差异、城区和县各型手足口病报告发病率的差异、地区和县重症率的差异及死亡率的差异。结果2009-2018年全市共报告手足口病确诊病例7258例,平均报告发病率17.04/10万,Cox A16型、其他肠道病毒和EV71型手足口病平均报告发病率分别为1.68/10万、3.15/10万、12.21/10万;株洲市手足口病确诊病例主要发病时间为4-7月和10-12月,EV71型亦相同。男女确诊手足口病报告发病比例为1.32∶1;5岁及以下儿童确诊病例占全部确诊病例的95.54%,各型手足口病1~<2岁年龄组报告发病率最高;各地区确诊手足口病平均报告发病率在3.24/10万~53.34/10万之间,城区手足口病平均报告发病率高于县,差异均有统计学意义(χ2=7333.36,P=0.000);手足口病确诊病例重症率为1.14%,重症病死率为18.07%;城区与县确诊病例重症率的差异无统计学意义(χ2=1.13,P=0.267),而二者重症病例死亡率差异具有统计学意义(χ2=10.63,P=0.001)。结论株洲市目前手足口病的优势病原体是EV71病毒,确诊病例、重症病例和死亡病例中EV71感染占大多数,控制EV71感染的手足口病将可以有效降低株洲市手足口病的报告发病率,减少手足口病重症病例以及病死病例。

Objective Analyzing the epidemiological characteristics and the main virus types of confirmed HFMD in Zhuzhou city from 2009 to 2018,the reference was provided for prevention and control of HFMD in the whole city.Methods The data of laboratory diagnosis of HFMD in China's disease prevention and control information system was used to analyze the epidemiological characteristics,and the difference in the reported incidence of Cox-A16-type,the other enterovirus-type and EV71-type HFMD by every year,the difference in the reported incidence of all types of HFMD in urban areas and counties,the difference in regional and county critical and mortality,were compared by Chi-square test.Results From 2009 to 2018,a total of 7,258 confirmed cases of HFMD were reported in the city,with an average reported incidence of 17.04/105.The average reported incidences of CoxA16-type,the other enterovirus-type and EV71-type HFMD are 1.68/105,3.15/105,and 12.21/105.The confirmed cases mainly occurred in April to July and October to December,the same months as the main cases of EV71-type.The proportion of reported confirmed HFMD between men and women was 1.32∶1.The concentration of confirmed HFMD among children under the age of 5(95.54%);The highest incidence of each confirmed cases was reported in the 1-<2 age group;the number of diagnosed HFMD in each district ranged from 3.24/105 to 53.34/105.The average reported morbidity of diagnosed HFMD in urban areas was higher than that in the counties,and the difference was statistically significant(χ2=7333.36,P=0.000).The severe case rate of confirmed cases of HFMD was 1.14%,and the severe case fatality rate was 18.07%;the severe case rate of confirmed cases in urban and county areas was not statistically significant(χ2=1.13,P=0.267),The severe case fatality rate of confirmed cases was statistically significant(χ2=10.63,P=0.000).Conclusion The dominant pathogen of HFMD in Zhuzhou City is EV71 virus,which infections account for the majority of confirmed cases,severe cases and death cases.Controlling EV71 infection of HFMD will effectively reduce the reported incidence of HFMD in Zhuzhou City,and reduce severe cases and deaths of HFMD.