EV71型手足口病疫苗的效果评价

目的了解EV71型手足口病疫苗的效果。方法收集2009～2018年手足口病疫情资料,资料来源于国家疾病监测信息管理系统。2016年8月开始购进疫苗,2016～2018年疫苗接种数由各县区上报,病原学结果自2012年开始检测,收集2012～2018年病原学结果。回顾性分析手足口病资料。通过观察2016～2018年EV71型手足口病疫苗的接种数与发病情况的关系,评价疫苗的效果。结果发病年龄主要集中在1岁组和2岁组,分别占40.44%和25.72%。2012年EV71构成比为24.42%,2013年65.57%,2014年22.03%,2015年59.29%,2016年18.70%,2017年32.20%,2018年10.29%,2013年、2015年、2017年EV71是优势菌株。2016年病例数5333例,发病率62.74/10万,2017年病例数是3991例,发病率46.29/10万,2018年病例数4823例,发病率55.21/10万。2017年EV71型重症病例仅有5例,比2013年15例下降66.7%,比2015年19例下降73.68%。2012～2018年手足口病重症病例中EV71型平均阳性率是81.67%。结论 5岁以内特别是1～2岁组是发病的高峰期,2017年EV71是优势菌株。2017年发病率和发病数均低于2016年和2018年。EV71病毒易致重症,2017年EV71流行强度和重症数低于2013年和2015年。虽然接种EV71型手足口病疫苗不能预防所有类型的手足口病,只对EV71型手足口病有效,但能降低发病率和重症率,是目前最经济、最有效的预防手段。

Evaluation of the effect of type EV71 vaccine for hand,foot and mouth disease

Objective]?To understand the effect of type EV71 vaccine for hand,foot and mouth disease.Methods?The data on hand,foot and mouth disease epidemics in 2009-2018 were collected.The data were retrieved from the National Disease Surveillance Information Management System.The vaccines were purchased starting from August 2016,the number of vaccinations in 2016-2018 was reported by the counties and districts,and the etiological results were tested starting from 2012.The etiological results were collected for 2012-2018.Retrospective analysis was carried out on the data of hand,foot and mouth disease.The effect of the vaccine was evaluated by observing the relationship between the number of vaccinations of type EV71 vaccine for hand-foot-and-mouth disease and the incidence of the disease in 2016-2018.Results?The age of onset was mainly around the one-year old group and the two-year old group,accounting for 40.44%and 25.72%respectively.In 2012,the composition ratio of EV71 was 24.42%and 65.57%in 2013,22.03%in 2014,59.29%in 2015,18.70%in 2016,32.20%in 2017,and 10.29%in 2018.In 2013,2015 and 2017,EV71 was the dominant strain.In 2016,there were 5333 cases of hand,foot and mouth disease,with an incidence rate of 62.74/100000.The number of cases in 2017 was 3991,and the incidence rate was 46.29/100000.In 2018,the number of cases was 4823,and the incidence rate was 55.21/100000.In 2017,there were only 5 severe cases of EV71,which fell 66.7%from 15 cases in 2013,and fell 73.68%from 19 cases in 2015.The average positive rate of EV71 in severe cases of hand,foot and mouth disease in 2012-2018 was 81.67%.ConclusionThe onset peak period is within 5 years of age,especially for the 1-2 years old groups.In 2017,EV71 is the dominant strain.The incidence rate and number of incidence in 2017 were lower than those in 2016 and 2018.EV71 virus is prone to cause serious illness,and the EV71 epidemic intensity and number of severity in 2017 were lower than those in 2013 and 2015.Although vaccination of EV71 vaccine for hand,foot and mouth disease cannot prevent all types of hand,foot and mouth disease,it is only effective for EV71 type hand,foot and mouth disease.However,this vaccine reduces the incidence rate and critical rate,which is the most economical and effective prevention method so far.