福建省南平市2012—2021年手足口病流行特征

Epidemiological characteristics of hand,foot and mouth disease in Nanping City,Fujian Province from 2012 to 2021

目的分析福建省南平市手足口病流行特征,为制定有效防制措施及评价防治效果提供依据。方法对南平市2012—2021年手足口病发病资料运用描述性流行病学方法进行分析。结果南平市2012—2021年累计报告手足口病49231例,10年间发病波动较大,发病率76.10/10万~308.93/10万,年均发病率184.99/10万,发病数和发病率整体呈现波动下降趋势,但隔年高发,不同年份报告发病率差异有统计学意义(χ^(2)=8169.176,P<0.001)。各地区发病情况差异较大,年均发病率前3位为光泽县(370.76/10万)、政和县(295.31/10万)和武夷山市(250.31/10万);季节分布明显,呈现2个发病高峰,5—6月为第一个发病高峰,9—10月为第二个发病小高峰;男性发病率(215.86/10万)高于女性(152.93/10万),男性比女性更易感(RR=1.412,95%CI=1.387~1.438);病例以0~4岁为主,占86.25%(42461/49231),随年龄增长发病率逐渐下降(χ^(2)_(趋势)=570105.801,P<0.001);散居儿童85.22%(41953/49231)为主,其次是幼托儿童12.39%(6101/49231)。病原学结果显示,累计报告实验室诊断病例3476例。每年3种(类)肠道病毒阳性比例各不相同,呈动态变化,不同年度病原构成差异有统计学意义(χ^(2)=584.613,P<0.001)。除2015—2017年以Cox A16型和EV71型为优势毒株,其他年份均以其他肠道病毒为优势毒株;EV71型是南平市重症及死亡病例的主要型别。结论南平市仍要加强对散居和幼托儿童的卫生健康教育,加强疫情、病原学监测和EV71疫苗接种,重视其他肠道病毒的检测和分型,做好手足口防控工作。

Objective To analyze the epidemic characteristics of hand,foot and mouth disease(HFMD)in Nanping City,Fujian province and to provide the basis for formulating effective prevention and control measures as well as evaluating the efficacy of prevention and treatment.Methods Descriptive epidemiological method was used to analyze the incidence data of HFMD in Nanping City from 2012 to 2021.Results A total of 49231 cases of HFMD were reported in Nanping City from 2012 to 2021.The incidence fluctuated greatly over the 10-year period,ranging from 76.10/100000 to 308.93/100000,with an average incidence of 184.99/100000 per year.The overall incidence and the number of cases showed a fluctuating downward trend over time,but the incidence was high in the next year,and there were statistically significant differences in the incidence rates between different years(χ^(2)=8169.176,P<0.001).There were significant regional differences in the incidence,the top three average annual incidence rates were:Guanze County(370.76/100000),Zhenghe County(295.31/100000)and Wuyishan City(250.31/100000).There were two peaks of HFMD incidence each year,with the first occurring in May and June and the second occurring in September and October.The incidence rate was higher among males(215.86/100000)than females(152.93/100000),and males were more susceptible than females(RR=1.412,95%CI=1.387-1.438).The cases were mainly aged 0-4 years,accounting for 86.25%(42461/49231)of all cases,and the incidence rate gradually decreased with increasing age(χ^(2)_(trend)=570,105.801,P<0.001).The majority of cases(85.22%,41953/49231)occurred in children living in scattered areas,followed by children in kindergartens(12.39%,6101/49231).The etiological results showed a total of 3476 laboratoryconfirmed cases,and the proportion of three(classes)of enterovirus positivity varied each year,with different pathogen compositions showing statistical significance(χ^(2)=584.613,P<0.001).In addition to the years 2015-2017,during which Cox A16 and EV71 were the dominant strains,other years were dominated by other enteroviruses,with EV71 being the main type in severe and fatal cases of HFMD in Nanping City.Conclusion Nanping City should strengthen health education for children living in the diaspora and in day-care centers,enhance surveillance of epidemics and pathogenology,improve vaccination rates against EV71,focus on the detection and typing of other enteroviruses,and implement effective prevention and control measures for HFMD.