2010—2019年阜新市手足口病流行病学特征分析

Analysis on epidemiological characteristics of hand,foot and mouth disease in Fuxin City from 2010-2019

目的了解2010—2019年阜新市手足口病的流行特征及变化趋势。方法采用描述流行病学方法对2010—2019年阜新市手足口病病例和病原学监测数据进行分析。结果2010—2019年阜新市共报告手足口病4468例,年均发病率为24.63/10万,重症11例,无死亡,不同年份发病率比较差异有统计学意义(P<0.01);10年间发病率双数年份增高。阜新市7个县(区)均出现不同程度的流行,总体流行强度依次为市区、县和郊区(P<0.01)。季节分布夏秋季单峰,7月为峰顶。年龄以5岁以下儿童为主(P<0.01),患者多为幼托儿童和散居儿童。10年间手足口病优势病原频繁交替,最优势病原为其他肠道病毒。影响病原阳性率的因素有不同标本类型、就诊机构级别、发病与采样时间间隔、发病月份。81.58%的托幼机构聚集性疫情发生在私立和农村托幼园所;聚集性疫情标本的人肠道病毒71型(EV71)阳性检出率高于全市和托幼机构检出率(P<0.05)。结论2010—2019年阜新市手足口病发病率呈现“偶数年升高”的周期性流行特点,有明显的季节性、年龄差异。防控重点时段在夏秋季,重点人群为5岁以下儿童,重点地区在市区,应警惕其它肠道病原引起的手足口病;聚集性疫情防控重点在私立和农村托幼园所,加强EV71手足口病疫苗的接种,以减少重症和聚集性疫情的发生。

Objective To understand the epidemic characteristics and change trend of hand,foot and mouth disease(HFMD)in Fuxin City from 2010-2019.Methods The descriptive epidemiology was used to analyze the data of HFMD cases and etiological surveillance in Fuxin City from 2010-2019.Results From 2010-2019,a total of 4468 HFMD cases were reported in Fuxin City,with an average annual incidence of 24.63/lakh,there were 11 severe cases and no death.The difference in incidence rate was statistically significant among different years(P<0.01).The incidence rate increased in the even years among ten years.All the seven counties(districts)inthecityshoweddifferentdegreesofepidemic,andtheoverallepidemicintensitywassuccessivelyinurbanarea,county and suburb(P<0.01).The seasonal distribution showed the single peak in summer and autumn,reaching peak in July.Most of the patients were children under 5 years old(P<0.01),mainlykindergarten children and scattered children.Over the past 10 years,the dominant pathogens of HFMD alternated frequently,and the most dominant pathogens were other enterovirus.The factors affecting the pathogen positive rate were different specimen types,the level of medical institution,the time interval between onset and sampling,and the month of onset.81.58%of the cluster outbreaks of in nurseries and kindergartens occurred in private and rural nurseries.The detection rate of enterovirus 71(EV71)in clustered epidemic specimens was higher than that in the he whole city and in nursery institutions(P<0.05).Conclusion The incidence rate of HFMD in Fuxin City from 2010-2019 shows the characteristics of periodic epidemic in even years,with obvious seasonal and age differences.The prevention and control should focus on the period of summer and autumn,population of children under 5 years old,and the region of urban area,and the attention should be paid to hand foot mouth disease caused by other intestinal pathogens.The prevention and control of the clustered epidemic should focus on private and rural nursery schools,and the vaccination of EV71 HFMD vaccine should be strengthened to reduce the occurrence of severe cases and clustered epidemic.