2005-2017年深圳市手足口病聚集性疫情流行特征及病原学分析

Analysis on epidemiological characteristics and etiology of hand-foot-mouth disease outbreaks in Shenzhen,2005-2017

目的掌握深圳市手足口病聚集性疫情的流行特征及病原学结果,为聚集性疫情高发场所的预防控制工作提供科学依据。方法利用描述性研究方法对2005-2017年深圳市报告的手足口病聚集性疫情进行统计分析,探讨疫情发生特征及防控措施。结果 2005-2017年深圳市共报告手足口病聚集性疫情889起,发病4 914例,罹患率为6.64%。疫情总体呈上升趋势(趋势线分析R2=0.655 6),但每起疫情的平均发病数呈下降趋势(趋势线分析R2=0.715 6)。疫情高发季节为4-6月和9-10月,共报告698起疫情,占疫情总数的78.52%。全市各区均有疫情报告,报告疫情起数居前三位的区包括南山区、龙岗区和罗湖区,共报告560起,占全市疫情总数的62.99%。幼儿园是手足口病聚集性疫情的主要发生单位,共报告829起,占疫情总数的93.25%。共对752起疫情进行了采样及检测工作,其中,其他肠道病毒阳性占31.25%,EV71阳性占28.59%,CA16阳性占27.79%。近年其他肠道病毒构成比不断上升并成为优势毒株。在疫情报告及时性方面,疫情发生时间-报告时间间隔最长39 d,最短在疫情发生当天即上报,中位数为4 d,平均报告时间间隔为4.72 d。在疫情发生后5 d内报告的疫情共546起,占61.42%。结论幼儿园是手足口病聚集性疫情的重点防控场所,早发现、早报告、早处置是防控的关键。做好学校、托幼机构的手足口病聚集性暴发疫情控制工作,也有利于控制手足口病在社区中的暴发与流行。

Objective To understand the epidemiological characteristics of outbreaks of hand-foot-mouth disease(HFMD)in Shenzhen and provide scientific evidence for HFMD control and prevention in high-risk institutions.Methods Descriptive method was used to analyze the data on HFMD outbreaks of Shenzhen from 2005 to 2017,and explore the characteristics of outbreaks and prevention measures.Results A total of 889 HFMD outbreaks with 4 914 cases were reported in Shenzhen from 2005 to 2017,and the attack rate was 6.64%.Overall,the number of outbreaks rose gradually(trendline analysis R2=0.655 6),but the average number of cases per outbreak declined(trendline analysis R2=0.715 6).The outbreaks were mainly reported during the period from April to June and September to October,with a total of 698 cases,accounting for 78.52%.The outbreaks were reported in every district of Shenzhen.Most outbreaks were reported in Nanshan District,Longgang District and Luohu District,with a total of 560 outbreaks,accounting for 62.99%.The HFMD outbreaks mainly occurred in kindergartens,with a total of 829 outbreaks,accounting for 93.25%.A total of 752 outbreaks were collected sample and tested,of which 31.25%were positive for other enteroviruses,28.59%were positive for EV71,and 27.79%were positive for CA16.The proportion of other enteroviruses was rising from 2015 to 2017,and other enteroviruses became the advantage pathogen at present.For timeliness of report,the longest time interval from outbreak occurred to report was 39 days,and the shortest time interval of that was 0 day,which meant the outbreak was reported on the day occurred.The median of interval was 4 days.546 outbreaks were reported within 5 days after the outbreak occurred,accounting for 61.42%.Conclusion Kindergartens were the key prevention and control places for HFMD outbreaks.Early detection,early reporting,and early control should be the keys to HFMD prevention and control.Good performance on control and prevention of HFMD outbreaks in kindergartens,primary and secondary schools would benefit to control the outbreaks and epidemics in communities as well.