蚌埠市2008—2016年手足口病流行特征分析

目的 通过对手足口病报告和监测资料的分析,探讨手足口病流行特点和规律,为防控提供科学依据。 方法 利用国家疾病监测信息管理系统,对蚌埠市2008-2016年手足口病监测资料进行分析。其中部分病例由哨点医院采集咽拭子标本,采用RT-PCR的方法,由市疾控中心进行肠道病毒核酸检测。 结果 2008-2016年共报告蚌埠市手足口病病例65 464例,年均报告发病率218.48/10万,其中市区271.32/10万,县域194.98/10万,市区高于农村(χ2=189.35,P<0.001)。5岁及以下儿童占病例总数的96.67%(63 286/65 464),其中3岁以下占74.09%(48 502/65 464)。33例重症病例中实验室诊断13例,其中EV71占构成比的76.92%(10/13),6例死亡病例全部为EV71。病原分型2013年以前奇数年以EV71为绝对流行株,偶数年EV71和Cox-A16混合流行,2014-2016年其他肠道病毒占了较大比重。临床病例核酸检测阳性率46.62%(1 588/3 406),阳性率在不同采样时间之间差异有统计学意义(χ2=104.292,P<0.001)。 结论 蚌埠市手足口病处于较高的流行水平,具有较明显的地区性、季节性和人群性,重症和死亡病例的流行优势毒株为EV71,其他肠道病毒逐渐成为近年来的流行毒株。监测工作应尽早采集病例标本并送检。 

Epidemiology of hand foot mouth disease in Bengbu city, 2008-2016

Objective To explore epidemiological characteristic of hand foot and mouth disease (HFMD) in Bengbu city by analyzing the report and monitoring data for providing scientific basis for prevention and control strategies. Methods We analyzed the monitoring data from 2008 to 2016 in the National Disease Surveillance Information Management System. The swabs of some cases were collected by the sentinel hospital and the detection of intestinal virus nucleic acid was carried out using the method of RT-PCR by the Bengbu center for disease control (CDC). Results A total of 65 464 HFMD including 33 severe cases and 6 fatal cases were reported in Bengbu city from 2008 to 2016, with an average annual incidence rate of 218.48/100 000, 271.32/100 000 in the city and 194.98/100 000 in the country. The city is higher than rural (χ2=189.35, P<0.01). The majority of cases were children below 5 years old, accounting for 96.67% (63 286/65 464). Children under 3 years old accounted for 74.09%(48 502/65 464). There are 13 laboratory diagnosed cases among 33 severe cases. The proportion of cases which had been diagnosed as enterovirus 71 (EV71) positive was 76.92%(10/13). Moreover, the death cases were all confirmed as EV71. Before 2013, EV71 was the only major etiological agents of HFMD in children in every odd-numbered year and in every even-number year EV71 and Cox-A16 were all the major etiological agents of HFMD. However, from 2014 to 2016 the detection rate of other enterovirus increased gradually. The positive rate of nucleic acid detection in clinical cases was 46.62% (1 588/3 406), and there was a statistical difference between the positive rate and the sampling time (χ2=104.292, P<0.01). Conclusion HFMD in Bengbu city has higher level of prevalence, as well as obvious regional, seasonal and crowd high-risk characteristic. EV71 is still the main cause of severe disease and death in HFMD and other intestinal viruses is increasingly becoming the epidemic strain. Case specimens should be collected and submitted as soon as possible.