2009—2020年益阳市手足口病流行病学特征分析

Epidemiological characteristics of hand,foot and mouth disease in Yiyang City,2009-2020

目的掌握2009—2020年益阳市手足口病的主要流行特征、流行规律,为防控工作提供科学依据。方法在中国疾病预防控制信息系统传染病监测系统中获取2009—2020年益阳市手足口病发病数据,从益阳市疾病预防控制中心获取病原学监测数据,采用描述性流行病学方法和SPSS 20.0软件对手足口病发病资料进行统计分析。结果2009—2020年,益阳市共报告手足口病病例123400例,死亡11例。2009年发病率最低(82.36/10万),2014年发病率(382.07/10万)最高。疾病的季节性呈双峰流行,主高峰为4—7月(占58.26%),次峰为10—11月;男女发病率差异无统计学意义(χ2=18.200,P=0.077);≤5岁儿童组发病人数最多,占96.05%;职业分布上,散居儿童占87.30%,幼托儿童病例占9.84%。2010—2020年共检测手足口病病例标本4578份,病原阳性率为63.54%,肠道病毒71型(EV71)和柯萨奇病毒A组16型(CoxA16)阳性构成比分别为20.04%和24.75%。各年不同病毒分型构成比差异有统计学意义(χ2=363.550,P<0.001)。聚集性疫情主要发生乡镇幼托机构(21起)。结论益阳市手足口病自2014年以来呈下降趋势,重点防控人群是≤5岁儿童,重点防控场所为乡镇幼托机构;应关注优势病原体的变化,不同年份检出的优势肠道病毒,相应调整防控措施。

Objective To understand the main epidemic characteristics and epidemic law of hand,foot and mouth disease(HFMD)in Yiyang City from 2009 to 2020,and to provide a scientific basis for prevention and control work.Methods The data concerning HFMD incidence in Yiyang from 2009 to 2020 were obtained from the Monitoring System for Infectious Diseases in China’s Disease Prevention and Control Information System,and the etiological monitoring data were acquired from Yiyang Center for Disease Control and Prevention.Descriptive epidemiological methods and SPSS 20.0 software were used for statistical analysis of the incidence data of HFMD.Results A total of 123,400 cases of HFMD were reported in Yiyang City from 2009 to 2020,including 11 deaths.The incidence rate in 2009 was the lowest(82.36/100,000),while the incidence rate in 2014 was the highest(382.07/100,000).Disease seasonality showed a double-peak pattern,with the main peak occurring in April-July(accounting for 58.26%)and a subsidiary peak appearing in October-November.No statistically significant difference was found in the incidence rates of males and females(χ2=18.200,P=0.077).Most of the cases were children aged 5 years and below,accounting for 96.05%.In terms of occupational distribution,scattered children accounted for 87.30%,and cases of preschoolers for 9.84%.A total of 4,578 samples of HFMD cases were detected from 2010 to 2020,with the pathogen positive rate of 63.54%.The positive constituent ratios of enterovirus 71(EV71)and coxsackievirus A group 16(CoxA16)strains were 20.04%and 24.75%,respectively.There were statistically significant differences in the constituent ratios of different virus types in each year(χ2=363.550,P<0.001).The aggregated epidemic mainly occurred in township kindergartens(21 outbreaks).Conclusion HFMD in Yiyang City showed a downward trend since 2014.The key prevention and control groups are children aged 5 years and below,and township nursery institutions are the key prevention and control places.We should pay attention to the changes of dominant pathogens as well as the dominant enteroviruses detected in different years,and adjust prevention and control measures accordingly.