2013—2022年长沙市6岁及以上人群手足口病流行特征分析

Analysis on the epidemiological characteristics of hand,foot and mouth disease in population aged 6 and over in Changsha,2013-2022

目的了解湖南省长沙市6岁及以上人群手足口病流行特征,为手足口病防控提供科学依据。方法通过中国疾病预防控制信息系统获取2013—2022年长沙市手足口病报告病例基本信息,同时收集各县(市、区)手足口病病原学监测数据。采用描述流行病学方法分析病例三间分布及病原构成变化。结果2013—2022年长沙市累计报告6岁及以上人群手足口病病例14889例,占手足口病总病例数的5.04%,无重症和死亡病例报告,年均报告发病率为19.54/10万。2013—2022年该人群病例在总病例数中的构成比总体呈上升趋势(χ^(2)_(趋势)=1658.760,P<0.01),每年发病主高峰出现在4—7月。性别分布上,男性8526例,女性6363例,性别比为1.34∶1;年龄中位数为7(6,10)岁,最大年龄为91岁,年龄分布以6~15岁为主,占88.09%(13116/14889);职业分布以学生为主,占55.97%(8334/14889)。城区(雨花区、开福区、岳麓区、芙蓉区和天心区)的年均报告发病率为24.70/10万,高于郊区(长沙县、浏阳市、宁乡市和望城区)的年均报告发病率(12.75/10万)。病原学监测结果显示,送检标本的肠道病毒阳性率为50.49%(156/309),其中肠道病毒A组71型(enterovirus A71,EV-A71)、柯萨奇病毒A组16型(coxasckievirus A16,CV-A16)和其他肠道病毒的构成比分别为5.77%(9/156)、37.18%(58/156)和57.05%(89/156)。结论2013—2022年长沙市手足口病病例中,6岁及以上人群占比总体呈升高趋势,以其他肠道病毒为主。建议密切关注6岁及以上人群的手足口病预防工作,加强中小学校手足口病防控措施,同时做好其他肠道病毒分型监测工作。

Objective To investigate the epidemiological characteristics of hand,foot and mouth disease(HFMD)in the population aged 6 and above in Changsha,Hunan Province,for scientific basis in prevention and control of this infection.Methods The basic information of reported cases of HFMD in Changsha from 2013 to 2022 was obtained through the China Information System for Disease Control and Prevention,and the etiological monitoring data of handfoot-mouth disease in each county(city,district)were collected.Descriptive epidemiological methods were used to analyze the temporal,regional and population distribution and pathogenic composition of the cases.Results A total of 14889 cases of HFMD were reported in the population aged 6 and above from 2013 to 2022,which accounted for 5.04%of the total number of HFMD cases.No severe or fatal cases were reported.The average annual reported incidence was 19.54 per 100000.The proportion of cases in this group showed an increasing trend in the total number of cases(χ^(2)_( trend)=1658.760,P<0.01).The annual peak of the disease occurred in April to July.Of the reported cases,8526 were males,and 6363 females,with a sex ratio of 1.34∶1.The median age was 7(6,10)years old.Maximum age was 91 years old,and the proportion of 6-15 years old was 88.09%(13116/14889).The occupation distribution was mainly involved in students,accounting for 55.97%(8334/14889).The average annual reported incidence within the urban areas(Yuhua District,Kaifu District,Yuelu District,Furong District and Tianxin District)was 24.70/100000,which was higher than that in the suburbs(Changsha County,Liuyang City,Ningxiang City and Wangcheng District;12.75/100000).Etiological monitoring showed that the positive rate of enterovirus in pathogenic specimens was 50.49%(156/309).The composition of enterovirus A71(EV-A71),coxasckievirus A16(CV-A16)and other enteroviruses was 5.77%(9/156),37.18%(58/156)and 57.05%(89/156),respectively.Conclusion From 2013 to 2022,the proportion of HFMD cases in the population aged 6 and above in Changsha area showed an increasing trend,mainly other enteroviruses.Our findings suggest that attention should be paid to the prevention of HFMD in population aged 6 and above,strengthen the prevention and control measures of hand-foot-mouth disease in primary and secondary schools,and do a good job in monitoring other enterovirus typing.