2015~2019年菏泽市手足口病流行特征分析

Analysis on epidemiological characteristics of hand-foot-mouth disease, Heze city,2015-2019

目的了解菏泽市手足口病(HFMD)流行病学和病原学特征,为制定HFMD预防控制措施提供依据。方法通过描述性研究对2015~2019年HFMD病例资料进行回顾性分析。结果 2015~2019年菏泽市共报告HFMD病例27 720例,年均发病率为64.49/10万,不同年份发病率差异有统计学意义(P<0.01)。2015~2017年报告病例呈下降趋势,但2017~2019年报告病例开始逐年上升。男性发病率大于女性(P<0.01),男女性别比是1.70∶1;5岁以下儿童16 721例,占全部HFMD病例的96.40%,主要是散居儿童(占91.57%)和幼托儿童(占6.70%);主要集中在3~7月,共20 180例(占72.78%)。报告病例居前3位的是牡丹区、鄄城和郓城,共14 245例(占51.37%);病原学检测共2 695例,阳性2 220例(占81.63%)。阳性病例中,EV71型699例(占31.77%),CA16型457例(占20.77%),其他肠道病毒1 039例(占47.23%),EV71和CA16合并感染5例(占0.23%)。2015年优势病毒是EV71(占68.40%),2016~2018年是其他肠道病毒(分别占44.51%、49.36%和83.26%),2019年是CA16(占55.98%)。在病原学特征方面,不同年份呈现出不同的优势病原流行。结论菏泽市HFMD发病有明显季节性、地区和人群特点。

Objective To understand the epidemiological and etiological characteristics of hand-foot-mouth disease(HFMD) in Heze city, so as to provide the evidence for establishing the prevention and control strategies of HFMD. Methods Descriptive research was performed to retrospectively analyze the incidence data of HFMD in Heze city during 2015-2019. Results A total of 27 720 cases of HFMD were reported in Heze city, the annual average morbidity was 64.49/10;.The morbidity of HFMD decreased from 2015 to 2017,increased from 2017 to 2019.Males had a higher annual incidence than that of females(P<0.01),with the ratio of 1.70∶1.A total of 16 721 cases were 0-5 years old, accounting for 96.40% of all cases, most of which were preschool(6.70%)and scattered children(91.57%).Incidence achieved the peak from March to July.A total of 20 180 cases were reported, accounting for 72.78%.There were statistical significant difference in the morbidity among different years(P<0.01).The top 3 countries were Mudan distict, Juancheng country and Yuncheng country.A total of 14 245 HFMD cases were reported(51.37%).A total of 2 695 samples were detected from 2015 to 2019,and the positive samples were 2 220 cases(81.63%).Among the positive cases, 699 cases was infected by EV71(31.77%),457 cases was infected by CA16(20.77%),1 039 cases was infected by other enterovirus(47.23%),5 cases was infected by EV71 and CA16(0.23%).The dominant pathogen was EV71 in 2015,other pathogens from 2016 to 2018,CA16 in 2019.There was statistical significant difference in the distribution of virus typing among different years(P<0.01). Conclusion The incidence of HFMD in Heze city presents obvious seasonality, regional characteristics and special population distribution.