2013-2018年北京市西城区手足口病特征分析

Analysis on epidemiological characteristics of hand-foot-mouth disease in Xicheng district of Beijing,2013-2018

目的分析北京市西城区手足口病(hand-food-mouth disease,HFMD)发病情况,为更好地开展肠道病毒71型(enterovirus71,EV71)疫苗接种和手足口病防控提供参考依据。方法利用描述流行病学方法对2013-2018年北京市西城区手足口病监测资料和2016-2018年EV71疫苗接种资料进行统计分析。结果2013-2018年西城区累计报告手足口病6544例,重症10例,年均发病率为83.09/10万,2014年和2018年分别出现发病高峰。每年发病高峰主要在6-8月,年均发病率前3位是广外、新街口和德胜街道。报告发病率以≤5岁儿童为主,占78.33%。职业分布以散居和托幼儿童为主,分别占39.90%和43.18%。共报告实验室确诊病例1244例,病原学监测总阳性率为70.34%。其中,EV71、柯萨奇病毒A组16型(coxsackievirus A16,CoxA16)和其他肠道病毒阳性率分别为13.68%、17.53%和39.14%。2016年9月-2018年12月西城区共接种EV71疫苗9026剂次,2017年和2018年估算接种率分别为4.68%和14.94%。2017-2018年和2013-2016年相比,EV71型病毒构成下降明显(χ2=18.951,P<0.001),其他肠道病毒上升明显(χ2=115.902,P<0.001)。结论北京市西城区手足口病的时间、地区和人群分布特征明显,2013-2018年手足口病发病率有下降趋势。随着EV71疫苗使用,优势肠道病原构成发生变化,建议加大EV71疫苗的使用和多价手足口病相关疫苗的研发。

Objective To analyze the the incidence of hand-foot-mouth disease(HFMD)in Xicheng district of Beijing,so as to provide a reference for improving enterovirus 71(EV71)vaccine inoculation and the prevention and control HFMD.Methods Using the descriptive epidemiology method,we analyzed the monitoring data of EV71 vaccine inoculation from 2016 to 2018 and HFMD from 2013 to 2018.Results 6544 cases of HFMD were reported from 2013 to 2018,including 10 severe cases.The average annual incidence rate was 83.09/100000,the incidence peak occurred in 2014 and 2018.The annual incidence peak was during June-August.The top three streets with the highest average annual incidence were Guang-wai,Xin Jie-kou and De-sheng.The main HFMD cases were children under 5 years accounting for 78.33%.The scattered children accounted for 39.90%,and the preschool cases accounted for 43.18%.1244 cases were laboratory confirmed cases,the total positive rate was 70.37%.The positive rate of human EV71,coxsackievirus A16(CoxA16)and other EV were 13.68%,17.53%and 39.14%respectively.A total of 9026 doses of enterovirus vaccine were administered from September 2016 to December 2018,and estimated vaccination rate of 2017 and 2018 were 4.68%and 14.94%.Compared with 2013-2016,the composition of EV71 virus decreased significantly in 2017-2018(χ2=18.951,P<0.001),while other enterovirus increased significantly(χ2=115.902,P<0.001).Conclusions HFMD had obvious characteristics in time,region and population distribution in Xicheng district of Beijing,the incidence of HFMD had a drop tendency in 2013-2018.With the use of EV71 vaccine,the types of predominant pathogens of HFMD has changed year by year.It is suggested that the development of multivalent HFMD-related vaccine and use of EV71 vaccine.