四川省什邡市2011—2019年手足口病病例特征及实验室检测结果分析

Characteristics and laboratory analysis of hand-foot-mouth disease from 2011 to 2019 in Shifang city, Sichuan province of China

目的分析2011—2019年什邡市手足口病流行病学特征及病原学特点,为科学防治手足口病、调整手足口病防控方案提供依据。方法通过中国疾病预防控制信息系统收集2011—2019年什邡市报告的所有手足口病病例资料,采用描述性流行病学方法分析手足口病流行病学特征,使用逆转录聚合酶链反应(reverse transcription-polymerase chain reaction, RT-PCR)进行病原学检测。结果 2011—2019年什邡市累计报告手足口病患者6 155例,主要为散居儿童(60.78%,3 741/6 155),患者年龄主要集中在5岁以下(97.30%,5 989/6 155)。城区所在的方亭街道报告患者最多(年均报告发病率220.31/10万),区域经济较为发达的两个镇次之,分别是师古镇(年均报告发病率148.63/10万)和洛水镇(年均报告发病率162.33/10万)。2011—2019年报告发病数呈双高峰上升趋势,2014年达到峰值,2015—2018年维持在较高水平,2019年达到次高峰;全年各月发病数仍呈双高峰分布,具有明显季节性,在4月(13.08%,805/6 155)达到峰值后逐渐减少,此为第一个高峰,也是全年最高峰,在11月(14.74%,907/6 155)达峰值后于12月下降,形成第二个高峰。报告病例主要来源于什邡市市内医疗机构(93.71%,5 768/6 155);病原学构成中,主要为其他肠道病毒(41.38%,132/319)和柯萨奇病毒A组16型(36.68%,117/319)。结论 2011—2019年什邡市手足口病报告发病率呈上升趋势,具有流行强度大、高峰持续时间长的特点,应加强重点人群、重点环节、重点单位的防控工作。

Objective To study the epidemiological and etiological characteristics of hand-foot-mouth disease(HFMD) in Shifang city from 2011 to 2019. Methods The epidemiological characteristics of HFMD cases in Shifang city from 2011 to 2019 were analyzed, and the virus genes were detected by reverse transcription-polymerase chain reaction(RT-PCR). Results A total of 6 155 HFMD cases were reported in Shifang city from 2011 to 2019, mainly scattered children(60.78%, 3 741/6 155).The majority of cases were found in children under 5 years old(97.30%, 5 989/6 155).The Fangting street reported most of the cases with an average annual reported incidence of 220.31/100 000.Shigu town with an average annual reported incidence rate of 148.63/100 000 and Luoshui town with an average annual reported incidence rate of 162.33/100 000 followed, both with relatively developed regional economy.The number of reported cases presented an upward trend with double peaks from 2011 to 2019 peaked in 2014.It maintained at a high level from 2015 to 2018 and reached a second peak in 2019.Monthly case distribution in every year remained to be a double-peak trend, showing a seasonal pattern.The case numbers gradually decreased after reaching the first and highest peak in April(13.08%,805/6 155)and the second peak appeared in November(14.74%,907/6 155).The reported cases were mainly collected from medical institutions in Shifang city(93.71%,5 768/6 155).The etiological cases were mainly composed of enteroviruses(41.38%,132/319)and coxsackie virus A group 16(36.68%,117/319). Conclusions From 2011 to 2019,the reported incidence of HFMD in Shifang city presents an upward trend with a high epidemic intensity and long peak duration,which indicates that prevention and control should be strengthened for risk population,links and organizations.