2007年至2021年北京市单中心儿童传染病的流行特征分析

Epidemiological characteristics of childhood infectious diseases in a single center in Beijing City from 2007 to 2021

目的分析2007年至2021年北京市单中心就诊儿童传染病患者的传染病流行特征,为医院传染病疫情管理提供科学依据。方法收集2007年1月1日至2021年12月31日首都医科大学附属北京儿童医院全民健康信息化疾病预防控制信息系统中记录的门诊就诊或住院的年龄<18周岁儿童传染病患者的临床资料,通过描述性流行病学方法,分析传染病病种、人群分布、时间分布特点,以及主要传染病的病原学特征。结果共诊治儿童传染病患者219260例,占全院诊治病例总数的5.73‰(219260/38295800),2010年和2019年出现2次发病高峰,分别为25469例和22928例。传染病病种以丙类传染病为主,占77.51%(169947/219260)。根据传播途径分类,粪-口传播传染病最常见,为144712例(66.00%),空气飞沫传播传染病73946例(33.73%),其呈逐年上升趋势。发病前5位的疾病为手足口病(114864例)、流行性感冒(28703例)、水痘(22190例)、其他感染性腹泻病(21040例)和猩红热(11500例)。219260例患儿中,男131546例,女87714例,男女比为1.5∶1;以≤6岁儿童为主要人群,共189593例(86.47%);5月至7月为传染病报告的高峰期。手足口病病原体以柯萨奇病毒A组16型(CV-A16)为主,占35.02%(1258/3592),自2017年起柯萨奇病毒A组6型(CV-A6)构成比呈快速上升趋势。流行性感冒病原体以甲型流行性感冒病毒为主,占62.18%(7400/11900)。其他感染性腹泻病的病原体以轮状病毒为主,占87.55%(4283/4892)。结论儿童传染病间断出现发病高峰,近年来空气飞沫传播传染病呈上升趋势。手足口病、流行性感冒、水痘、其他感染性腹泻病和猩红热为影响儿童的主要传染病,不同疾病存在年龄和发病季节特点,传统的传染病防治工作重点应该根据传染病的流行趋势变化逐步更新,做好高峰季节、重点人群的防护。

Objective To analyze the epidemiological characteristics of childhood infectious diseases in a single center in Beijing City from 2007 to 2021,and to provide scientific basis for the management of infectious diseases in hospitals.Methods The clinical data of outpatients or inpatients aged<18 years old with infectious diseases recorded in the Nationwide Health Information-based Disease Control and Prevention Information System of Beijing Children′s Hospital,Capital Medical University from January 1,2007 to December 31,2021 were collected.Descriptive epidemiological methods were used to analyze the types of infectious diseases,population distribution,time distribution characteristics,as well as the etiological characteristics of major infectious diseases.Results There were 219260 cases reported,accounting for 5.73‰(219260/38295800)of the total number of hospital cases,with two peaks of 25469 and 22928 cases in 2010 and 2019,respectively.The main category of infectious diseases was class C,accounting for 77.51%(169947/219260).According to the classification of transmission routes,fecal-oral transmission infectious diseases were the most common,with 144712 cases(66.00%),followed by air and droplet transmission infectious diseases with 73946 cases(33.73%),showing an increasing trend by year.The top five diseases in terms of incidence were hand,foot and mouth disease(114864 cases),influenza(28703 cases),varicella(22190 cases),other infectious diarrheal diseases(21040 cases)and scarlet fever(11500 cases).Among the 219260 children,there were 131546 males and 87714 females,with a male-to-female ratio of 1.5 to 1.Children aged≤6 years old comprised the majority,with a total of 189593 cases(86.47%).The peak period of infectious diseases reporting was from May to July.Hand,foot and mouth disease was mainly caused by Coxsackie virus A16(35.02%(1258/3592)),while Coxsackie virus A6 had been increasing rapidly since 2017.The main pathogen of influenza was influenza A virus(62.18%(7400/11900)),while other infectious diarrhea was mainly caused by rotavirus(87.55%(4283/4892)).Conclusions There is an intermittent outbreak in the incidence of childhood infectious diseases,and air and droplet transmission infectious diseases have shown an upward trend in recent years.Hand,foot and mouth disease,influenza,varicella,other infectious diarrheal diseases and scarlet fever are the main infectious diseases affecting children.Different diseases have the characteristics of age and onset season.The prevention and control of infectious diseases should be updated gradually according to the epidemic trend.Proper protection should be taken during peak seasons and for key populations.