四川省遂宁市2011-2015年手足口病疫情和病原学监测分析

目的 了解四川省遂宁市手足口病的流行特征和病原学构成,分析手足口病重症病例的高危因素.方法 对《传染病报告信息管理系统》中导出的遂宁市2011-2015年手足口病个案卡片以及遂宁市疾病预防控制中心实验室提供的病原学监测数据进行分析,描述疫情的分布情况以及病原学分类构成,并利用Logistic回归分析重症手足口病的高危因素.结果 遂宁市2011-2015年手足口病年均罹患率为65.82/10万,重症率为4.83‰,病死率为0.19‰,重症病死率为38.46‰;发病高峰分别为每年的3-5月和10-11月;发病年龄主要集中在3岁以下(9 133例,占84.84％),男女比例为1.59:1(x2=108.72,P＜0.01),以散居儿童为主(8 168例,占75.93％),其次是幼托儿童(2 362例,占21.96％),重症病例中以散居儿童为主(47例,占90.38％),不同人群手足口病重症率差异具有统计学意义(x2-1 1.95,P＜0.05).5年间手足口病监测采样730例,阳性413例,总阳性率56.58％,病原学以其他肠道病毒为优势毒株(阳性率34.66％),其次是肠道病毒71型(阳性率14.25％).多因素分析显示肠道病毒71型和柯萨奇病毒16型感染病例发生重症的风险分别增加3.44倍和4.74倍.结论 遂宁市手足口病发病呈逐年上升的趋势且具有明显的季节性,重点人群为3岁以下儿童,肠道病毒71型和柯萨奇病毒16型感染病例发生重症的风险增加.

Epidemiology and etiological surveillance of hand-foot-mouth disease in Suining City,Sichuan Province,2011-2015

Objective To investigate the epidemiological characteristics and virus constitution of hand-footmouth disease in Suining City,and analyze the high risk factors of severe cases.Methods The case cards of handfoot-mouth disease in Suining City from 2011 to 2015 derived from infectious disease reporting information management system and the etiological monitoring data provided by laboratory of Suining Center for Disease Control and Prevention were analyzed.The general epidemic situation and the pathogenic classification were described,andthe risk factors of severe hand-foot-mouth disease were explored by Logistic regression.Results The annual average incidence,severe rate,mortality rate and severe mortality rate of hand-foot-mouth disease in Suining City during 2011 and 2015 were 65.82/100 000,4.83‰,0.19‰ and 38.46‰,respectively.Two incidence peaks respectively were from March to May and from October to November.Age of onsetwas mainly concentrated under 3 years old (9 133 cases,84.84％),and the male and female ratio was 1.59:1 (x2=108.72,P＜0.01).The crowd classification was mainly concentrated in the scattered children (8 168 cases,75.93％),followed by preschool children (2 362 cases,21.96％),while the severe cases was mainly scattered children (47 cases,90.38％).There were significant differences in the severe rates of hand-foot-mouth disease among different crowd classification,which had statistical significance (x2=11.95,P＜0.05).There were 730 samples collected in 5 years,in which 413 samples were positive (56.58％),and other enterovirus was the dominant strain (positive rate was 34.66％),followed by enterovirus 71 (positive rate was 14.25％).Multivariate analysis showed that the risks of severe cases with enterovirus 71 and coxsackievirus A16 positive were increased 3.44 times and 4.74 times respectively.Conclusions The incidence of hand-foot-mouth disease in Suining City is increasing year by year and with obvious seasonality.The focus group of hand-foot-mouth disease is of children under 3 years old.The enterovirus 71 and coxsackievirus A 16 infection will increase the risk of severe cases.