四川广元地区手足口病儿童肠道病毒流行病学及病原学分析

Epidemiology and pathogen composition of enterovirus in children with hand,foot and mouth disease in Guangyuan,Sichuan

目的探讨广元地区手足口病儿童肠道病毒的流行病学及病原构成特征,为制定手足口病防控策略提供依据。方法随机抽取2019年1月至2021年1月广元地区临床诊断手足口病患儿759例,采用描述流行病学方法对手足口发病的季节、年龄、性别、区域分布及病原体的分布特点进行分析。结果手足口病发病具有明显的季节性,呈典型的双峰分布,分别是4~7月的夏季发病高峰(χ^(2)=8.714,P<0.05)和10~12月的冬季发病高峰(χ^(2)=7.542,P<0.05)地区间发病率差异较大,城市发病率远高于农村(χ^(2)=5.915,P<0.05);男女发病率比例为(1.63/1);手足口病的高发人群为<5岁儿童报告发病例数为730例高发年龄段为1~3岁(χ^(2)=8.455,P<0.05),≤5岁各年龄组发病数呈现男性高于女性的特征,差异有统计学意义(χ^(2)=5.174,P<0.05);手足口病病例实验室检测病毒核酸阳性388份,阳性率为51.12%,轻症病例中Cox A16型、EV71型、其他肠道病毒分别占27.64%、29.54%和42.82%;重症病例EV71的构成比为89.47%。结论广元地区手足口病广泛分布,季节性和人群差异明显,应加强重点区域、高发季节和重点人群的防控,进一步推进≤3岁儿童疫苗接种,防止引起手足口病暴发流行。

Objective To investigate the epidemiology and pathogenic characteristics of enterovirus in children with hand,foot and mouth disease(HFMD)in Guangyuan area,and to provide a basis for the development of HFMD prevention and control strategies.Methods A total of 759 children with HFMD clinically diagnosed in Guangyuan area from January 2019 to January 2021 were randomly selected.The seasonal,age,gender,regional distribution and pathogen distribution characteristics of HFMD were analyzed by descriptive epidemiological methods.Results The incidence of HFMD was seasonal and presented a typical bimodal distribution,with the summer peak occurring from April to July(χ^(2)=8.714,P<0.05)and the winter peak from October to December(χ^(2)=7.542,P<0.05).There was a significant difference in the incidence rate between regions,and the incidence rate in urban areas was much higher than that in rural areas(χ^(2)=5.915,P<0.05).The male-female incidence ratio was 1.63∶1.The high incidence group of HFMD was children younger than 5 years old,and the number of reported cases was 730.The high incidence age group was 1-3 years old(χ^(2)=8.455,P<0.05).The incidence rate of HFMD in all age groups≤5 years old was higher in male than female,and the difference was statistically significant(χ^(2)=5.174,P<0.05).A total of 388 HFMD cases were tested positive for viral nucleic acid,with a positive rate of 51.12%,In mild cases,Cox A16,EV71,and other enteroviruses accounted for 27.64%,29.54%and 29.54%,respectively.The proportion of EV71 in severe cases was 89.47%.Conclusion HFMD is widely distributed in Guangyuan area,with obvious seasonal and population differences.The prevention and control of HFMD should be strengthened in key areas,high incidence seasons and key populations,and the vaccination of children≤3 years old should be further promoted to prevent the outbreak of HFMD.