2009-2017年天津市河北区手足口病流行特征分析

Analysis on the epidemiologic characteristics of hand foot and mouth disease in Hebei District of Tianjin in 2009-2017

目的手足口病是由肠道病毒感染引起的一种儿童常见传染病,<5岁儿童多发。本研究分析天津市河北区2009-2017年手足口病发病情况,为制定手足口病防治策略提供依据。方法对2009-2017年天津市河北区手足口病发病率年份、季节、区域和人群分布特征等进行描述性统计分析,对2010-2017年病例病原学检测结果进行分型组间构成比χ2检验。结果 2009-2017年累计报告手足口病4 844例,其中死亡病例1例。年平均发病率为61.96/10万,2010年发病率最高,为89.35/10万,2009年发病率最低,为28.91/10万。手足口病的发病呈明显的季节性,6、7月份达到高峰,占发病总数的46.14%(2 235/4 844);建昌道街、月牙河街年平均发病率较高,分别为147.21/10万、106.92/10万;男性发病多于女性,男女性别比为1.42∶1;病例以≤6岁学龄前儿童为主,占总发病数的87.76%;职业以托幼儿童和散居儿童为主,二者占总发病数的86.96%。564例病原学检测阳性率73.05%,EV71、CoxA16和其他肠道病毒分别占28.64%、29.61%和41.75%,不同年份病毒分型构成差异有统计学意义,χ2=96.16,P<0.001。结论河北区手足口病季节、地区、性别、年龄及人群分布特征明显。呈隔年流行的模式,发病集中在夏季,城乡结合部多发,好发于<6岁儿童;主要病原体逐年变迁。需针对高发季节和高发人群制定相应防控措施,落实宣教、加强流动人口管理及加强幼儿园管理等对手足口病防控至关重要。

OBJECTIVE Hand foot and mouth disease(HFMD)is a common infectious disease in children caused by enterovirus infection,which occurs frequently in children under 5 years old.To analyze HFMD in Hebei District of Tianjin from 2009 to 2017,and to provide evidence for formulating strategies for prevention and control the disease.METHODS The data of the incidence rate of HFMD in Hebei District of Tianjin from 2009 to 2017 was analyzed,and the distribution characteristics of year,season,region and population were also investigated.Etiological data of the 2010-2017 cases was classified by chi square test.RESULTS From 2009 to 2017,there were 4 844 patients falling in Hand foot and mouth disease with 1 fatal case.The average annual incidence rate was 61.96/100 000.The highest incidence rate was89.35/100 000 in 2010 and the lowest was 28.91/100 000 in 2009.The incidence of HFMD was seasonal,peaking in June and July,accounting for 46.14%(2 235/4 844)of the total incidence.The average annual incidence rate of Jianchangdao(147.21/100 000)and Yueyahe(106.92/100 000)were higher than other subdistricts.The incidence of male was more than that of female,the ratio of male to female was 1.42∶1.And the age of patients were always between 0 and 6 years old,which had taken 87.76%totally.Nursery school children and scattered children were the mainly occupation,accounted for 86.96%of the total number of diseases.The positive rate of pathogenic examination with 564 cases was 73.05%,EV71,CoxA16 and other enterovirus accounted for 28.64%,29.61%and 41.75%,respectively.There were statistical differences in viral typing in different years(χ2=96.16,P<0.001).CONCLUSIONS Seasonal,regional,gender,age and population distribution characteristics were obvious of HFMD in Hebei District.It shows the pattern of popular every other year,the incidence peak is in summer,and people of urban-rural fringe and people under 6 years of age are at high-risk.The types of predominant virus change year by year.Prevention and control measures should be developed for high incident seasons and high incidence populations.It is critical for prevention and control of HFMD to unfold extensive publicity and education,strengthen the management of floating population and kindergartens.