中国2008--2009年手足口病报告病例流行病学特征分析

目的 了解2008-2009年中国手足口病流行时间、区域和人群分布以及病原构成.方法 利用2008-2009年疾病监测信息系统报告的手足口病例对其流行病学特征进行分析.结果 (1)2008和2009年全国报告手足口病例分别为488955例和1155525例,发病率为37.01/10万和87.01/10万,重症病例数为1165例和13810例,死亡126例和353例.(2)高、中、低纬度地区报告发病率分别为50.09/10万、68.47/10万和59.04/10万.(3)2009年中、低纬度地区12～24周为发病高峰期;高纬度地区23～35周为流行高峰期;第二个流行峰仅波及低、中纬度地区,高纬度地区不明显.(4)病例主要集中在5岁及以下儿童,占发病总数的92.23%,2岁组儿童发病率最高,重症和死亡病例集中在低年龄组儿童的特点更为明显,0岁组儿童发生重症的比例和病死率最高,随着年龄增加各年龄组重症比例及病死率依次降低.(5)不同类型病例病原构成存在差异.相对于普通病例,重症和死亡病例肠道病毒71型(EV71)检测阳性的危险度分别为1.82和2.11,且病原构成存在季节变化.(6)2008-2009年共发生聚集性病例疫情477起,幼托机构发生疫情为389起,占总起数的81.21%,村庄发生疫情47起,占总起数的9.81%;聚集性病例疫情发生时间主要集中在4-7月.结论 2009年中国手足口病流行强度增强.不同纬度地区流行强度不同,季节分布存在差异,5岁及以下儿童是发病主要人群,年龄越小发生重症和死亡的风险越高,EV71和柯萨奇病毒A16型为主要病原,聚集性病例高发场所为托幼机构和村庄.

Abstract：

Objective To clarify the seasonal and geographical difference and pathogen patterns so as to provide reference of prevention and control of the disease through analyzing the epidemical characteristics of reported hand-foot-mouth disease(HFMD)cases in China,2008-2009.Methods We analysed the epidemiological data of HFMD from the Chinese national notifiable infectious diseases reporting system in 2008 and 2009.Results There were 488 955 and 1155525 reported HFMD cases in 2008 and 2009,in China,of which 1165 and 13810 were severe and 126 and 353 were fatal,respectively.The notification rates were 50.09/10 million,68.47/10 million and 59.04/10 million in high,medium and low latitudes areas,respectively.The epidemic periods in Medium and Low latitude were from 12 to 24 weeks in 2009,and in high latitude it was from 23 to 35 weeks.HFMD cases were concentrated mainly in 5 year-old or even younger children,accounted for 92.23% of the total cases.The incidence rate of two years old appeared to be the highest.The features of severe and death case concentrated in lower age groups were more evident,and the proportion of severe case and case fatality rate under 1 vears old was higher than that in other age groups.We also noticed that with the increasing of age,the proportion of severe case and case fatality rate had a decreasing trend.There was a difference between the pathogens seen.The relative risk(RR)for an human enterovirus 71(HEV71)isolate was higher among severe case than in common cases(RR=1.82),whereas the RR for an EV71 isolate was higher among the death cases than in common cases (RR=2.11).There was seasonal variation of pathogen composition.There were 477 clusters of cases from 2008 to 2009,of which 389 found in preschools,47 in rural villages,outbreaks of clusters were mainly from April to July. Conclusion The HFMD epidemics was increasing in 2009.The epidemic of HFMD in different latitudes area and seasons was different.Children of five year old or under were the major population groups at risk,of HFMD.The younger ones had higher risk of becoming severe and death cases.HEV71 and coxsackievirus A16 were both the major etiologic agents of HFMD.The preschool and rural villages were the main senings of clusters of cases.

Epidemiological features of hand, foot and mouth disease in China, 2008 - 2009

Objective To clarify the seasonal and geographical difference and pathogen patterns so as to provide reference of prevention and control of the disease through analyzing the epidemical characteristics of reported hand-foot-mouth disease(HFMD)cases in China,2008-2009.Methods We analysed the epidemiological data of HFMD from the Chinese national notifiable infectious diseases reporting system in 2008 and 2009.Results There were 488 955 and 1155525 reported HFMD cases in 2008 and 2009,in China,of which 1165 and 13810 were severe and 126 and 353 were fatal,respectively.The notification rates were 50.09/10 million,68.47/10 million and 59.04/10 million in high,medium and low latitudes areas,respectively.The epidemic periods in Medium and Low latitude were from 12 to 24 weeks in 2009,and in high latitude it was from 23 to 35 weeks.HFMD cases were concentrated mainly in 5 year-old or even younger children,accounted for 92.23% of the total cases.The incidence rate of two years old appeared to be the highest.The features of severe and death case concentrated in lower age groups were more evident,and the proportion of severe case and case fatality rate under 1 vears old was higher than that in other age groups.We also noticed that with the increasing of age,the proportion of severe case and case fatality rate had a decreasing trend.There was a difference between the pathogens seen.The relative risk(RR)for an human enterovirus 71(HEV71)isolate was higher among severe case than in common cases(RR=1.82),whereas the RR for an EV71 isolate was higher among the death cases than in common cases (RR=2.11).There was seasonal variation of pathogen composition.There were 477 clusters of cases from 2008 to 2009,of which 389 found in preschools,47 in rural villages,outbreaks of clusters were mainly from April to July. Conclusion The HFMD epidemics was increasing in 2009.The epidemic of HFMD in different latitudes area and seasons was different.Children of five year old or under were the major population groups at risk,of HFMD.The younger ones had higher risk of becoming severe and death cases.HEV71 and coxsackievirus A16 were both the major etiologic agents of HFMD.The preschool and rural villages were the main senings of clusters of cases.