2016-2020年内蒙古自治区手足口病流行病学特征分析

Epidemiological characteristics of hand, foot and mouth disease in Inner Mongolia, 2016-2020

目的 分析2016-2020年内蒙古自治区手足口病流行病学及病原学特征,为制定手足口病防控措施提供科学参考依据。方法 收集中国疾病预防控制信息系统中2016-2020年内蒙古自治区手足口病报告病例及病原学监测数据,采用描述性流行病学方法,分析其三间分布特征和病原学构成特点。结果 2016-2020年内蒙古自治区累计报告手足口病57 486例,其中重症218例,死亡2例。2016-2019年报告病例数及发病率均处于丙类传染病第一位次。发病呈明显季节性分布,有两个发病高峰,分别为5—8月和9-12月。12个盟市中,5年平均发病率最高的是鄂尔多斯市(96.77/10万),最低的为乌兰察布市(16.68/10万),不同盟市间发病率差异有统计学意义(χ^(2)=257.504,P<0.01)。男性发病人数高于女性,男女性别比例为1.36∶1。报告病例主要集中在0~<5岁组,占82.63%,5岁以上人群随年龄增长报告病例数所占比例呈现明显下降趋势;各年龄组中,3~<4岁组发病率最高,为44.74/10万,9~<10岁组发病率最低,为3.35/10万,各年龄组发病率差异有统计学意义(χ^(2)=2 565.91,P<0.01)。职业分布主要为幼托儿童、散居儿童和学生。2017年流行优势病原以EV-A71型为主(1 170/2 478,占47.22%),2016年以CVA16型为主(738/1 565,占47.16%),2018-2020年则以其他肠道病毒为主(分别占67.51%、53.87%和87.50%),不同年份之间手足口病的病原体构成比差异有统计学意义(χ^(2)=1 829.794,P<0.01)。结论 内蒙古自治区手足口病发病率、重症比、病死率均呈下降趋势,且发病具有明显的时间、地区和人群分布特征。应提高肠道病毒EV-A71型灭活疫苗接种率,加强幼托机构等场所的防控工作,有效预防手足口病疫情发生。

Objective To understand the epidemiological and etiological characteristics of hand, foot and mouth disease(HFMD) in Inner Mongolia during 2016 and 2020, and to provide a scientific reference for formulating prevention and control measures for HFMD. Methods Data of reported cases and etiological surveillancedata of HFMD in Inner Mongolia from 2016 to 2020 were collected. Descriptive epidemiological methods were used to analyze the characteristics of disease distribution and pathogenic composition. Results From 2016 to 2020, a total of 57 486 cases of HFMD were reported in Inner Mongolia, including 218 severe cases and 2 deaths. Both annual reported case number and the annual incidence in 2016-2019 were on the top of class C infectious diseases. There were two seasonal peaks of HFMD, which were from May to August and from September to December.The incidence varied significantly among 12 alliance cities(χ^(2)=257.504, P<0.01) with the highest of 96.77/100 000 in Erduosi and the lowest of 16.68/100 000 in Wulanchabu. The incidence was higher in males than that in females with the ratio of 1.36∶1. Majority of the reported cases were in 0-5 years old group, accounting for 82.63%, and the percentage of cases decreased with age among those over 5 years. The incidence of HFMD also varied significantly among age groups(χ^(2)= 2 565.91, P<0.01) with the highest of 44.74/100 000 in the age group of 3-<4 and the lowest of 3.35/100 000 in the age group of 9-<10. Most cases were preschool children, scatter-populated children and students. There was significant difference in the pathogen composition of HFMD in different years(χ^(2)=1 829.794, P<0.01).The predominant pathogen shifted from EV-A71(1 170/2 478,47.22%) in 2017 to CVA16(738/1 565,47.16%) in 2016 and to other enterovirus(accounting for 67.51%,53.87% and 87.50%,respectively) in 2018—2020. Conclusions The incidence rate, percent of severe cases and mortality rate of HFMD in Inner Mongolia over the past five years all show downward trends. The disease has two seasonal peaks and distributes in different regions and age groups. In order to effectively prevent the outbreak of HFMD, we should widen the coverage of inactivated EV-A71 vaccination and strengthen the prevention and control work in nursery institutions and schools.