绵阳市涪城区2009—2019手足口病流行病学特征及病原学检测分析

Epidemiological characteristics and etiological analysis on hand-foot-mouth disease in Fucheng District,Mianyang City from 2009 to 2019

目的分析了解绵阳市涪城区2009—2019年手足口病流行病学特征及病原构成,为制定手足口病的预防与控制措施和策略提供科学依据。方法采用描述性流行病学方法对绵阳市涪城区2009—2019年报告的12692例手足口病病例流行病学资料及2902例病例的病原检测资料进行统计分析。结果涪城区2009—2019年共报告手足口病病例12692例,无死亡病例,年均报告发病率为187.80/10万,年均递增率为16.86%,未发生暴发疫情。各年手足口病报告发病率差异有统计学意义(χ^(2)=1995.84,P<0.01),发病呈上升趋势(χ^(2)_(趋势)=1170.58,P<0.01)。临床诊断病例9790例,实验室诊断2902例(EV 71感染249例、Cox A16感染640例、其它肠道病毒感染2013例),以其它肠道病毒感染为主(69.37%);轻型病例12569例(99.03%),重症病例123例(0.97%)。全年各月均有发病,主要集中在4—7月(51.64%)和10—12月(28.06%);城乡发病率差异有统计学意义(χ^(2)=575.21,P<0.01),城区发病率高于乡镇。发病年龄以1~<4岁组为主(77.14%),发病率达3397.25/10万;职业发病以散居儿童发病为主(56.33%);男女发病差异有统计学意义(χ^(2)=364.78,P<0.01),男性发病率高于女性。结论绵阳市涪城区需继续加强手足口病病原学监测,做好健康教育宣传,同时加强对4岁以下儿童EV 71疫苗的接种,采取综合干预预防措施和策略,降低手足口病的发生与流行。

Objective To analyze and understand the epidemiological characteristics and etiology composition with hand-foot-mouth disease reported in Fucheng District,Mianyang City from 2009 to 2019,and to provide scientific basis for preparing prevention and control measures and strategies for hand-foot-mouth disease.Methods The descriptive epidemiological method was used to statistically analyze epidemiological data of 12692 patients with hand-foot-mouth disease and etiology detection data of 2902 patients reported from 2009 to 2019 in Fucheng District,Mianyang City.Results A total of 12692 patients with hand-foot-mouth disease free from death were reported in Fucheng District from 2009 to 2019,the average annual incidence rate was 187.80/100000,and average annual increase rate was 16.86%.No outbreak occurred.The difference in the incidence of hand-foot-mouth disease reported annually was statistically significant(χ^(2)=1995.84,P<0.01),and the incidence showed an upward trend(χ^(2)_(trend)=1170.58,P<0.01).A total of 9790 patients were clinically diagnosed,2902 patients were diagnosed in the laboratory(249 patients infected with EV 71,640 patients infected with Cox A16,and 2013 infected with other enterovirus).Other enterovirus infections dominated(69.37%);12569 patients infected with mild infections(99.03%)and 123 patients with severe infections(0.97%).Incidence was happed in every month throughout the year,mainly concentrated from April to July(51.64%)or from October to December(28.06%);the difference in the incidence between urban and rural areas was statistically significant(χ^(2)=575.21,P<0.01),and the incidence in urban areas was higher than that in townships.The age of onset was mainly focused on the age group from 1 to<4 years(77.14%)with an incidence rate of 3397.25/100000;occupational incidence mainly dominated among scattered children(56.33%);the difference in incidence between men and women was statistically significant(χ^(2)=364.78,P<0.01),and the incidence of male attacks was higher than that of female attacks.Conclusion Fucheng District,Mianyang should further strengthen the etiological monitoring of hand-foot-mouth disease,properly handle the health education and publicity,tigthen inoculation of EV 71 vaccine for children under 4 years old,adopt comprehensive intervention and preventive measures and strategies to reduce the occurrence and prevalence of hand-foot-mouth disease.