肠道病毒71型灭活疫苗上市前后河南省濮阳市手足口病流行特征及病原学变化分析

Epidemiological characteristics and pathogenic changes of hand-footmouth disease before and after the launch of EV71 vaccine in Puyang city,Henan province

目的分析肠道病毒71型灭活疫苗(EV71疫苗)上市前后对河南省濮阳市手足口病流行特征和病原学变化的影响,为手足口病科学防控提供依据。方法通过“中国疾病预防控制中心传染病报告信息管理系统”收集濮阳市2009-2022年手足口病病例相关数据,并收集病原学监测结果,用描述性流行病学方法进行分析。结果2009-2022年濮阳市累计报告手足口病发病数57442例,年均发病率在14.84/10万~258.10/10万;EV71疫苗上市前后,年均发病率分别为131.84/10万、91.65/10万(P<0.05),重症(含死亡)病例占比分别为6.64%、2.78%(P<0.05)。发病时间主要在4-7月,病例男性高于女性,以1~3岁散居儿童为主;疫苗上市前后人群年龄、性别、职业分布构成比变化均存在统计学差异(P均<0.05);疫苗上市后各县区手足口病发病率均有不同程度的下降。疫苗上市前后,病原学监测普通病例EV71阳性率分别为19.99%、8.11%(P<0.05),重症病例监测EV71阳性率分别为60.53%、21.97%(P<0.05)。结论EV71疫苗上市后,有效预防控制了濮阳市手足口病的流行,特别是由EV71感染引起的手足口病的流行。

Objective To analyze the impact of EV71 vaccine on the epidemiological characteristics and pathogenic changes of hand-foot-mouth disease(HFMD)in Puyang city,Henan province,before and after its launch,so as to provide a basis for the scientific prevention and control of HFMD.Methods The relevant data of HFMD cases in Puyang from 2009 to 2022 were collected through the Chinese Center for Disease Control and Prevention Communicable Diseases Report Information Management System,and the pathogenic monitoring results were collected.The descriptive epidemiological methods were used for the analysis.Results From 2009 to 2022,57442 cases of HFMD were reported in Puyang city,with an average annual incidence rate ranging from 14.84/100000 to 258.10/100000.Before and after the launch of EV71 vaccine,the average annual incidence rate was 131.84/100000 and 91.65/100000,respectively(P<0.05),and the proportion of severe cases(including deaths)was 6.64%and 2.78%,respectively(P<0.05).The onset time was mainly from April to July;the number of cases in males was higher than that in females;the majority of cases were scattered-living children aged 1-3 years.There were statistical differences in age,sex and occupational distribution of the cases before and after the vaccine was launched(P<0.05).After the vaccine was launched,the incidence rate of HFMD in all counties and districts decreased to varying degrees.Before and after the launch of the vaccine,the positive rates of EV71 in pathogenic monitoring of general cases were 19.99%and 8.11%,respectively(P<0.05),while the positive rates of EV71 in severe cases monitored were 60.53%and 21.97%,respectively(P<0.05).Conclusions After the launch of EV71 vaccine,the prevalence of HFMD in Puyang city has been effectively prevented and controlled,especially the prevalence of HFMD caused by EV71 infection.