手足口病流行病学调查研究

手足口病是由多种肠道病毒引起的临床症候群,多发生于婴幼儿,可引起手、足、口腔、臀部等的疱疹,个别患者可引起心肌炎、肺水肿、无菌性脑膜脑炎等并发症.是夏秋季的常见病、多发病.本研究分析我院2008-2010年接诊的891例手足口病患儿的流行病学特点,指导今后预防保健工作.     

2011～2012年博州手足口病流行病学调查分析

目的了解新疆博尔塔拉蒙古自治州(博州)手足口病的发病情况,为防治提供科学依据。方法按QIAGEN试剂操作步骤提取RNA,用Real-time PCR方法进行核酸检测,Ct值在20~30以内为阳性。结果 2011~2012年共报告手足口病例408例,其中临床诊断309例,实验室诊断99例;本病全年均有发病,以6月发病最多,12月发病最少;男女性别比为1.87∶1;EV71阳性32份,阳性率32.32%,CoA16阳性20份,阳性率20.20%,其他肠道病毒阳性3份,阳性率3.03%;2011年以EV71为优势毒株,2012年以CoA16为优势毒株。结论加强托幼机构的管理,对儿童用具及时清洗消毒,发现可疑患病儿童及时就诊并居家治疗,积极开展健康教育工作,增强儿童和家长的自我防护意识,在手足口病监测和防控工作中,要考虑其流行特点,做到早发现、早预防、早诊治,减少疫情的发生,早期的病原监测应成为重要的公共卫生措施之一。     

新泰市暴发手足口病的流行病学调查及护理体会

2003年6月～2003年9月，新泰市出现手足口病(HFMD)暴发流行，发病人数多，病死率较高，现将其流行病学特点及护理体会报告如下。     

2011年成都市手足口病疫情

目的 为掌握成都市手足口病流行规律,有针对性提出防治措施建议.方法 通过国家疫情网收集2011年手足口病疫情信息,通过qRT - PCR方法实施病原体检测.结果 成都市2011年手足口病报告发病18284例,其中重症283例,死亡3例,年报告发病率125.22/10万,病死率低于全国平均水平,无暴发疫情发生.四季均发病,呈双峰流行,5岁以下儿童是主要发病人群,病原体优势毒株由EV71向CoxA16转变的趋势.结论 2011年成都市手足口病总体发病水平较高,但病死率低,无暴发疫情,早期预警和治疗可有效预防暴发和降低病死率.     

2009年邯郸市手足口病血清流行病学调查

目的掌握2009年邯郸市0～15岁儿童EV71IgG和CoxA16IgG携带状况,探讨发病率与抗体的关系。方法采用酶联免疫吸附试验(ELISA)检测0～15岁儿童血清EV71IgG和CoxA16IgG,分析EV71IgG、CoxA16IgG阳性率随年龄的变化趋势及其与手足口病发病率间的关系。结果 2009年邯郸市报告HFMD病例19 457例,567例HFMD病例标本中450份肠道病毒核酸阳性,其中EV71 302份(占67.11%),CoxA16 75份(占16.67%)。采集856名儿童血清,EV71IgG阳性546例,阳性率63.79%;CoxA16IgG阳性579例,阳性率67.64%,差异无统计学意义(χ2=1.309,P>0.05)。儿童血清EV71IgG和CoxA16IgG阳性率呈负相关(r=-0.900),5岁以下儿童血清EV71IgG阳性率与2009年HFMD发病率呈正相关关系(r=0.852),CoxA16IgG阳性率与发病率呈负相关关系(r=-0.816)。结论 2009年邯郸市CoxA16和EV71均有流行,病例以EV71型为主。     

2008～2011年安徽歙县手足口病流行病学特征

目的 掌握歙县手足口病流行病学特征,为制订预防控制措施提供科学依据.方法 采用描述性流行病学方法对2008年5月至2011年4月歙县手足口病流行病学个案调查资料和监测资料进行分析.结果 临床诊断手足口病715例,发病率48.3/10万(35.5/10万～63.6/10万).无重症和死亡病例;发病范围广,占乡镇的96.4％;发病季节性明显,主要集中在3～6月;病例以5岁以下儿童为主占89.0％;男性发病显著高于女性,性别比1:0.74;病原为CoxA16和EV71等肠道病毒.结论5岁以下儿童是手足口病的重点防控人群,应加强实验室检测,积极开展健康促进工作.     

2012-2020年黔西南州手足口病流行特征分析

目的 分析2012-2020年贵州省黔西南州手足口病的流行特征,为手足口病防控提供依据.方法 从中国疾病预防控制信息系统中获取2012-2020年黔西南州手足口病发病资料,利用描述流行病学方法分析数据.结果 2012-2020年黔西南州共报告手足口病30754例,年均发病率为120.44/10万,重症病例524例、重症率2.05/10万,死亡14例、死亡率0.05/10万;发病呈双峰分布,第一次发病高峰主要出现在3-7月,第二次发病高峰出现在10-12月;东部两县(贞丰县和望谟县)发病率明显低于全州年平均水平,各县(市、区)发病差异有统计学意义(x2=4304.285,P＜0.01);高发人群为5岁以下的散居儿童及托幼儿童;男女性别比1.63∶1;2012年和2014年主要以CoxA16型和EV 71型为优势毒株,自2015年以来以其他肠道病毒为优势毒株,但在流行高峰期间CoxA16型或EV 71型可成为优势毒株.结论 黔西南州手足口病发病有明显季节性,呈隔年高发趋势;应加强5岁以下儿童的防控,以降低发病率.     

2009～2011年钦州市手足口病流行病学特征分析

目的分析2009～2011年钦州市手足口病流行病学特征,为预防控制手足口病提供参考依据。方法对2009～2011年钦州市疾病监测信息报告系统上报的手足口病病例进行描述流行病学分析。结果 2009～2011年钦州市共报告手足口病病例9580例,重症病例63例,无死亡病例。年发病率在39.47/10万～204.19/10万之间,呈现上升趋势,男性发病高于女性,以散居儿童和幼托儿童为主,集中于0～5岁组,报告病例中<3岁的占82.66%,病原学检测手足口病标本334份,阳性115份,阳性率为34.43%,病例集中在4～6月份。结论 2009～2011年钦州市手足口病整体高发呈点多、面广、局部有暴发的流行特征。发病有明显的年龄、性别、职业和季节差异。做好5岁以下儿童手足口病防控工作是手足口病防控工作的重中之重。     

2008-2011年南充市高坪区手足口病流行病学分析

目的 了解南充市高坪区2008-2011年手足口病的流行病学特征,探索预防和控制手足口病的方法和措施.方法 采用描述性流行病学的方法对疫情进行分析.结果 2008-2011年南充市高坪区共报告手足口病318例,年均报告发病率为14.84/10万,重症2例,无死亡病例;发病高发时段为4-7月,占发病总数的62.58％;年龄分布在10岁以下人群,5岁以下最多,占发病总数的96.23％;男女性别比为2.06∶1;职业构成以散居儿童为主,占发病总数的69.18％.实验室确诊7例,EV71阳性1例.结论 2008-2011年南充市高坪区手足口病有明显的季节性,发病年主要集中在5岁以下人群,男性多于女性,防控重点为散居儿童和托幼儿童,加强健康教育,普及全民健康知识是预防和控制疫情的关键.     

2012—2017年城固县手足口病流行特征分析

目的分析2012—2017年陕西省城固县手足口病流行特征,探索手足口病发病变化趋势,为制定有效的防控对策提供参考依据。方法从中国疾病监测信息报告管理系统导出2012—2017年手足口病病例资料,采用描述流行病学方法分析手足口病病例的发病概况、流行病学特征及病原学检测结果。结果 2012—2017年城固县共报告手足口病病例2 834例,其中重症24例、死亡2例,年平均发病率101.28/10万,病死率70.57/10万;男性发病率124.00/10万、女性发病率78.20/10万,博望、上元观、柳林和原公镇病例最多,以散居儿童和托幼儿童为主、占96.47%,发病集中在5岁以下儿童、占95.59%,4—7月为发病高峰期,10—11月又呈现秋季小高峰;实验室诊断手足口病病例共98例,包括肠道病毒71型(EV71,27.55%)、柯萨奇病毒A16型(CoxA16,22.45%)和其他肠道病毒(50.0%),重症和死亡病例中EV71占41.67%。结论城固县手足口病有明显的季节性高发特征,托幼机构和散居儿童是防控的重点;针对易感人群和高发季节应持续加强疫情监测和健康教育,提高EV71疫苗接种率,有效预防和控制手足口病的发生和流行。     

2010年成都市青白江区手足口病疫情分析

目的 为了解2010年成都市青白江区手足口病流行病学特征,为制定和完善传染病防治策略和措施提供科学依据.方法 对2010年成都市青白江区手足口病疫情资料进行描述性流行病学分析,通过qRT- PCR方法对患者咽拭子、疱疹液等检测.结果 成都市青白江区2010年报告手足口病637例,年报告发病率160.59/10万,报告发病率居全区报告法定传染病第1位,占总发病例数的28.35％,男女性别比为1.56∶1,1～3岁发病数占74.89％,职业分布以散居儿童最多,占51.49％,其次为幼托儿童,占45.05％.全年均发病,4～6月和12月呈发病高峰.结论 成都市青白江区2010年手足口病报告发病率较高,应充分做好手足口病防治工作,落实防控措施,有效控制疫情发展.     

Targeted FMD Vaccines for Eastern Africa: The AgResults Foot and Mouth Disease Vaccine Challenge Project

As one of the most infectious livestock diseases in the world, foot and mouth disease (FMD) presents a constant global threat to animal trade and national economies. FMD remains a severe constraint on development and poverty reduction throughout the developing world due to many reasons, including the cost of control measures, closure of access to valuable global FMD-free markets for livestock products, production losses through reduced milk yield, reduced live weight gain, and the inability of infected livestock to perform traction. FMD virus infects a variety of cloven-hoofed animals, including cattle, sheep, goats, swine, all wild ruminants, and suidae, with high morbidity in adult animals. High mortality can occur in young animals due to myocarditis. FMD is endemic in Africa, most of Asia, the Middle East, and parts of South America. The global clustering of FMD viruses has been divided into seven virus pools, where multiple serotypes occur but within which are topotypes that remain mostly confined to that pool. Three pools cover Europe, the Middle East, and Asia; three pools cover Africa; and one pool covers the Americas. The highly infectious nature of FMDV, the existence of numerous continually circulating serotypes and associated topotypes, the potential for wildlife reservoirs, and the frequent emergence of new strains that are poorly matched to existing vaccines all serve to compound the difficulties faced by the governments of endemic countries to effectively control and reduce the burden of the disease at the national and regional levels. This clustering of viruses suggests that if vaccination is to be a major tool for control, each pool could benefit from the use of tailored or more specific vaccines relevant to the topotypes present in that pool, rather than a continued reliance on the currently more widely available vaccines. It should also be noted that, currently, there are varying degrees of effort to identify improved vaccines in different regions. There are relatively few targeted for use in Africa, while the developed world’s vaccine banks have a good stock of vaccines destined for emergency outbreak use in FMDV-free countries. The AgResults Foot and Mouth Disease (FMD) Vaccine Challenge Project (the “Project”) is an eight-year, US $17.68 million prize competition that supports the development and uptake of high-quality quadrivalent FMD vaccines tailored to meet the needs of Eastern Africa (EA). The Project targets the following Pool Four countries: Burundi, Ethiopia, Kenya, Rwanda, Tanzania and Uganda. The Project is being run in two phases: a development phase, which will encourage the production of regionally relevant vaccines, and a cost-share phase, designed to help to reduce the price of these vaccines in the marketplace to the end users, which is hoped will encourage broader uptake. Manufacturers can submit quadrivalent FMD vaccines containing serotypes A, O, SAT1, and SAT2, which will be assessed as relevant for use in the region through a unique component of the Project requiring the screening of vaccines against the Eastern Africa Foot and Mouth Disease Virus Reference Antigen Panel assembled by the World Reference Laboratory for FMD (WRLFMD), at the Pirbright Institute, UK, in collaboration with the OIE/FAO FMD Reference Laboratory Network. To be eligible for the Project, sera from vaccinated cattle will be used to evaluate serological responses of FMD vaccines for their suitability for use in Eastern African countries. If they pass a determined cut-off threshold, they will be confirmed as relevant for use in the region and will be entered into the Project’s cost-share phase.     

2011—2020年泉州市洛江区手足口病流行病学特征分析

目的 分析泉州市洛江区手足口病流行病学特征,为探讨和制定洛江区手足口病防控措施提供科学依据。方法 根据“中国疾病预防控制信息系统”传染病报告数据,收集2011年1月1日—2020年12月31日洛江区手足口病资料,应用描述性统计方法分析病例的时间、地区、人群等流行分布特征。结果 2011—2020年洛江区报告手足口病病例7 319例,重症病例1例,无死亡病例,发病率为25.00/10万~493.27/10万,年均发病率为324.14/10万,发病率呈现逐年降低趋势(χ^(2)_(趋势)=118.98,P<0.05);病例高峰主要出现在春夏季,秋季次之。各街道(乡镇)均有病例报告,其中万安街道(26.55%,1 943/7 319)、马甲镇(25.55%,1 870/7 319)、双阳街道(18.66%,1 366/7 319)病例分布较多,占总病例数的70.76%。男性病例4 721例,女性2 598例,性别比为1.82∶1;发病人群主要为散居儿童(69.95%,5 210/7 319),其次是幼托儿童(27.18%,1 989/7 319);5岁以下年龄组报告病例较多,占总病例数的91.57%。结论 洛江区手足口病疫情具有周期性、季节性变化特征,5岁以下儿童为高发人群,要加强对儿童手足口病防控力度。     

“四化管理”护理模式对手足口病患儿康复进程及生活质量影响

目的研究“四化管理”护理模式对手足口病患儿康复进程及生活质量影响。方法研究对象选取我院2017年5月-2019年5月间收治的手足口病患儿80例,根据回顾性分析,按照将其分为对照组和观察组,每组各40例。对照组患儿接受常规护理,观察组患儿接受“四化管理”护理模式干预。比较两组患儿的康复进程,同时比较对并发症以及患儿生活质量的影响。结果观察组患儿的康复进程时间均明显短于对照组(P<0.01);护理后,观察组患儿的生理功能、情感功能、社会功能、角色(学校表现)功能等生活质量指标评分均高于对照组(P<0.05)。两组患儿并发症发生情况比较无统计学差异(P>0.05)。结论“四化管理”护理模式干预在手足口病患儿恢复期的作用显著,可明显促进患儿的康复,加快进程,改善生活质量。     

Epidemiological Research on Hand,Foot, and Mouth Disease in Mainland China

Hand, foot, and mouth disease (HFMD), which has led to millions of attacks and several outbreaks across the world and become more predominant in Asia-Pacific Region, especially in Mainland China, is caused by several Human Enteroviruses including new enterovirus, coxsakievirus and echovirus. In recent years, much research has focused on the epidemiological characteristics of HFMD. In this article, multiple characteristics of HFMD such as basic epidemiology, etiology and molecular epidemiology; influencing factors; detection; and surveillance are reviewed, as these can be help protect high risks groups, prevalence prediction and policy making for disease prevention.     

Assessment of the Risk of Foot and Mouth Disease among Beef Cattle at Slaughter from East African Production Systems

Endemic foot and mouth disease (FMD) in East African cattle systems is one factor that limits access to export markets. The probability of FMD transmission associated with export from such systems have never been quantified and there is a need for data and analyses to guide strategies for livestock exports from regions where FMD remains endemic. The probability of infection among animals at slaughter is an important contributor to the risk of FMD transmission associated with the final beef product. In this study, we built a stochastic model to estimate the probability that beef cattle reach slaughter while infected with FMD virus for four production systems in two East African countries (Kenya and Uganda). Input values were derived from the primary literature and expert opinion. We found that the risk that FMD-infected animals reach slaughter under current conditions is high in both countries (median annual probability ranging from 0.05 among cattle from Kenyan feedlots to 0.62 from Ugandan semi-intensive systems). Cattle originating from feedlot and ranching systems in Kenya had the lowest overall probabilities of the eight systems evaluated. The final probabilities among cattle from all systems were sensitive to the likelihood of acquiring new infections en route to slaughter and especially the probability and extent of commingling with other cattle. These results give insight into factors that could be leveraged by potential interventions to lower the probability of FMD among beef cattle at slaughter. Such interventions should be evaluated considering the cost, logistics, and tradeoffs of each, ultimately guiding resource investment that is grounded in the values and capacity of each country.     

2015年湖南省手足口病流行特征分析

【摘要】 目的  分析2015年湖南省手足口病流行特征,探讨手足口病流行规律,为制订防控策略和控制措施提供科学依据。 方法  收集2015年湖南省疾病监测报告系统报告的手足口病病例资料、病原学监测资料和突发公共卫生事件报告管理系统报告的聚集性疫情资料进行描述性流行病学分析。 结果  2015年湖南省共报告手足口病病例135 628例,其中重症病例710例,死亡14例,发病率为201.32/10万;发病率较高的地区主要为湘中、湘东北和湘西地区;男女性别比为1.56∶1,5岁及以下年龄组病例占发病总数的97.01%;病原学监测阳性率为54.02%,普通病例、重症病例、死亡病例的EV71检出率分别为9.62%、29.48%和88.89%。 结论  湖南省手足口病发病有明显的季节性,高发人群是低龄儿童、散居儿童,不同血清型的毒株交替占主导地位,加强监测和风险评估、有效处置疫情和开展针对重点人群的健康教育是有效控制手足口病的关键。     

湖南省永兴县2008-2011年手足口病流行病学分析

目的 分析永兴县2008-2011年手足口病的发病动态和流行特征,为今后的防治工作提供依据.方法 采用描述流行病学方法,对疫情资料进行三间分布等分析.结果 共报告手足口病2010例,年均发病率为85.468/10万,其中重症20例,死亡3例.发病率以2011年最高,不同年份发病率差异有统计学意义(x2=583.192,P=0.000).各乡镇均有病例报告,其中马田、城关、樟树、柏林和湘阴渡为高发.发病高峰有2个:①4-7月,这一高峰明显而稳定;②10月前后,尚不清晰.发病以5岁以下儿童居多,占总发病数的94.826％.男女发病率差异有统计学意义(RR=2.051,95％CI 1.860～2.2