2009-2012年盐城市盐都区托幼机构手足口病流行病学特征

目的了解盐城市盐都区托幼机构手足口病流行特征，为制定防控措施提供参考依据。方法收集2009--2012年盐都区托幼机构手足口病病例，比较各年度发病率、发病人群、地域特征及病原分析结果。结果2009--2012年盐都区托幼机构共报告手足口病804例，其中重症7例，无死亡病例，75起聚集性病例；疫情呈现逐年上升趋势，成为当前盐都区托幼机构存在的与传染性疾病相关的严重的公共卫生问题。盐都区托幼机构手足口病发病主要集中在中小班级，男女性别发病比为1．87：1（524／280）；各区域托幼机构发病数和发病率均逐年上升，东部城郊各年份发病率明显高于中部农村和西部水乡，其中2011—2012年更表现为东部城郊区域流行暴发。2009--2012年托幼机构累计报告实验室确诊病例56例，占报告总数的6．97％；其中肠道病毒EV71型（EV71）29例，柯萨奇病毒A组16型（CoxA16）24例，其他肠道病毒3例，总检出率分别为49．15％、40．68％和5．08％。2009年EV71为优势毒株，2010年转变为CoxA16毒株，2011—2012年EV71和CoxA16均为优势毒株。4年间仅2011年监测重症病例7例，其中6例为EV71，1例为CoxA16。结论盐都区托幼机构手足口病疫情不断蔓延，存在明显的年龄、性别、地区和季节特征和差异，多种病毒株共存。当前防治措施仍以依法加强病例监测报告、控制托幼机构病例聚集和暴发、儿童监护人的健康教育和发病后及早就医为主，严防重症病例的发生。

Epidemic characteristics of HFMD in nurseries of Yandu District of Yancheng City from 2009-2012

Objective ] To understand the epidemic characteristics of Hand, foot and mouth disease （HFMD） in nurseries of Yan- du District of Yancheng City from 2009-2012, and provide reference for developing control measures. Methods] The HFMD cases in nurseries of Yandu District from 2009-2012 were collected for analysis of annual incidence, patients group, geographical charac- teristics and etiology. Results] A total of 804 cases of HFMD were reported in nurseries of Yandu District of Yancheng City from 2009-2012, with 7 severe cases, no death case and 75 collective cases. The HFMD epidemic showed an increasing trend which had become the serious infectious disease related public health problem existed in nurseries of Yandu District. The HFMD cases mainly concentrated in small and middle class. The ratio of male to female was 1.87：1 （524/280）. The case number and incidence in nurs- eries increased annually. The incidence in eastern suburbs was significandy higher than that in central rural areas and western water area, especially regional outbreaks in eastern suburbs from 2011-2012. A total of 56 laboratory-confirmed cases were reported in nurs- eries from 2009-2012, occupying 6.97% of total cases. There were 29 cases of EV71 （49.15% ）, 24 cases of CoxA16（40. 68% ） and 3 cases of other enteric viruses （5.08% ）. The prevailing strain was EV71 in 2009, CoxA16 in 2010, EV71and CoxA16 in 2011- 2012. During 4 years, only 7 severe cases were identified in 2011,6 cases of EV71, 1 of CoxA16. Conclusion] The HFMD is sprea- ding widely in nurseries of Yandu District, with obvious difference between age, gender and region, seasonal characteristics, various kinds of virus. The main control measures are strengthening case monitoring report, controlling case aggregation and outbreak, carry- ing out health education on guardians of children and early treatment to prevent the occurrence of severe cases.