2009—2019年常熟市手足口病流行特征及EV 71疫苗接种效果分析

Analysis on prevalence characteristics of HFMD and EV 71 vaccination effect in Changshu from 2009 to 2019

目的分析2009—2019年常熟市手足口病流行特征及EV 71疫苗接种效果,为制定有效防控策略提供科学依据。方法收集2009—2019年常熟市手足口病疫情监测数据和EV 71疫苗接种资料并进行整理分析,对发病时间、地区及人群进行系统聚类分析,率的比较采用χ^(2)检验。结果2009—2019年常熟市累计报告手足口病病例36502例,年均报告发病率为175.07/10万。发病高峰集中在5—7月(18380例,占50.35%);1~<4岁组高发(22724例,占62.25%);男性发病率高于女性(χ^(2)=1021.4,P<0.01);虞山街道发病率最高(326.11/10万)。聚集性疫情主要集中在5—6月(308起,占37.02%),其次为12月(150起,18.03%)。2015—2019年常熟市手足口病EV 71疫苗儿童累计接种19534人,疫苗接种后EV 71病原检出率及散居儿童发病均呈下降趋势[OR(95%CI)=0.78(0.74~0.81),χ^(2)=138.309,P<0.01]。结论常熟市手足口病发病处于较高水平,应采取针对性措施,加强集体单位疫情防控和病原学检测;EV 71疫苗可以有效防止同类病毒的感染,建议推广使用。

Objective To analyze the epidemic characteristics of hand-foot-mouth disease(HFMD)and effectiveness of enterovirus 71(EV 71)vaccination in Changshu from 2009 to 2019,and to provide the scientific basis for formulating effective prevention and control strategy.Methods The data of HFMD epidemic surveillance and EV 71 vaccination in Changshu from 2009 to 2019 were collected and analyzed.Systematic cluster analysis was conducted on the onset time,region and population,and the chi-square test was used to compare the incidence rates.Results A total of 36502 cases with HFMD with annually reported incidence of 175.07/100000 cases on average were reported in Changshu from 2009 to 2019.The peak time intensively extended from May to July(18380 cases,50.35%),and the maximum incidence rate was in the 1-3 years old group(22724 cases,62.25%);the incidence of male HFMD was significant higher than that of female HFMD(χ^(2)=1021.4,P<0.01);the incidence rate in Yushan Street was maximum(326.11/100000).The month of maximum cluster cases mainly concentrated on months from May to June(308,37.02%)and followed by December(150,18.03%).A total of 19534 children were inoculated with EV 71 vaccine against HFMD in Changshu 2015 to 2019.Both the detection rate of EV 71 pathogen and that of scattered children show downward trend after vaccination[OR(95%CI)=0.78(0.74-0.81),χ^(2)=138.309,P<0.01].Conclusion The incidence of HFMD in Changshu is at a relatively high level,targeted measures should be taken to strengthen epidemic prevention and pathogenic detection in personnel aggregation organization;EV 71 vaccine can effectively prevent the infection of similar viruses,and is advised to be popularized and used to control the pandemic.