2009-2020年钦州市手足口病流行病学及病原学分析

Epidemiological and Etiological Characteristics of Hand,Foot and Mouth Disease in Qinzhou from 2009 to 2020

目的:了解2009—2020年钦州市手足口病的流行病学及病原学特征,为手足口病防控提供科学依据。方法:通过中国疾病预防控制信息系统与儿童免疫规划信息系统获取手足口病病例信息与肠道病毒71型疫苗接种数据并进行描述性流行病学分析。结果:2009—2020年钦州市累计报告手足口病60652例,年均报告发病率为157.14/10万,累计报告重症病例1493例,重症占比为2.46%;死亡病例21例,年均死亡率为0.05/10万,病死率为0.03%。发病年龄主要分布在≤5岁儿童,占病例总数的92.89%﹔男女性别比为1.68∶1,男、女性手足口病发病水平差异具有统计学意义(χ^(2)=2169.19,P<0.05)。病例以散居儿童和幼托儿童为主,分别占报告病例总数的88.27%、8.97%。发病曲线除2017和2019年呈单峰分布外,其余年份呈双峰分布,春夏高峰为4—7月,秋冬高峰为9—10月,病原学特征上每年优势病原体有所变化,重症和死亡病例的优势病原为EV71,EV71疫苗的接种率仅为18.5%。结论:手足口病在钦州市存在明显的季节性和地区分布差异,优势病原体有所改变,散居儿童和幼托儿童为高危人群,应大力推广手足口病EV71疫苗的接种,加强宣传教育工作,加强疫情监测和病原分型监测,有效处理和控制疫情。

OBJECTIVE To understand the epidemic situation of Hand-foot-mouth disease(HFMD) in Qinzhou from 2009 to 2020, so as to provide scientific basis for the future prevention and control of hand-foot-mouth disease(HFMD). METHODS The information of HFMD and enterovirus 71(EV71) vaccine data were obtained from the Chinese Disease Prevention and Control Information System and the Childhood Immunization Program Information System, and descriptive epidemiological analysis was conducted.RESULTS 60 652 cases of HFMD were reported from 2009 to 2020, including 1 493 severe cases and 21 deaths. The average annual incidence rate was 157.14/100 000, the severe cases rate and fatality rate were 2.46% and 0. 03%. Cases in children aged 5 or younger accounted for 92.89%. The male was more than the female(χ^(2)=2169.19, P<0.05). The male-to-female ratio was 1.68:1.The scattered children and the kindergarten children accounted for 88.27% and 8.97%. Two peaks of incidence were observed every year expect 2017 and 2019, with the highest occurring between April and July and the second occurring between September and October. In terms of the etiological characteristics, the dominant pathogens changed annually. The dominant pathogen in severe and fatal cases was the EV71 with only 18.50 percent of vaccine coverage. CONCLUSION There were obvious seasonal and regional differences in the distribution of HFMD in Qinzhou, and the dominant pathogens had changed in recent years. The Scattered children and the kindergarten children were high risk groups. Therefore, it should promote the vaccination of HFMD EV71 vaccine, intensify efforts to publicize education and strengthen the monitoring and the pathogen typing surveillance, effective handling and control of the epidemic.