广东省病毒性脑炎流行特征分析

目的掌握广东省既往病毒性脑炎发病的本底情况及流行特征。方法 2012年6月,对广州、佛山、肇庆、云浮、茂名、梅州、汕头市辖区内的所有县(区)级及以上综合医院、妇幼保健院(儿童医院)等共141间医疗机构开展2009-2011年收治病毒性脑炎病例情况回顾调查。结果调查的141间医疗机构有93间医疗机构共收治病毒性脑炎病例7 259例,死亡227例,总的病死率为3.13%。2009-2011年7个市发病率的中位数分别为4.89/10万、5.14/10万和4.75/10万。病例发病高峰在每年的5-7月;病例主要分布在15岁以下儿童,占57.60%(4 181/7 259),其中,5岁以下儿童占57.12%(2 388/4 181)。死亡病例主要以15岁以下儿童为主,占76.21%(173/227)。208例为明确病原体的病例占全部病例的2.87%(208/7 259);其中,前三位的病原体分别为肠道病毒、EB病毒和乙型脑炎病毒。结论广东省病毒性脑炎有春夏季流行高峰,高发人群及病死率高的人群均为15岁以下儿童,建议在全省设置哨点医院,重点开展15岁以下儿童病毒性脑炎监测。

Epidemioligical characteristics of viral encephalitis in Guangdong province

Objective To understand the epidemiological features of viral encephalitis in Guangdong province. Method Viral encephalitis inpatients information were collected from district level and above general hospitals and Hospitals for Maternal and Child Health Care from 7 cities in Guangdong（Guangzhou, Foshan, Zhaoqing, Yunfu, Maoming, Meizhou and Shantou） during 2009 to 2011 in June 2012. Results 93 of the 141 hospitals investigated had admitted 7 259 viral encephalitis inpatients.Among them 227 died, and the fatality rate was 3.13%. The yearly median morbidities of 7 cities from 2009 to 2011 were 4.89 per 100 000, 5.14 per 100 000 and 4.75 per 100 000, respectively. The peak of disease attack was from May to July. The cases under 15 years old occupied 57.60%（4 181/7 259） of the total.Children under 5 years old occupied 57.12%（2 388/4 181） among the age group 〈15 years old. Most death happened on the age group under 15, with the ratio of 76.21%（173/227）. Among all inpatients 2.87%（208/7 259） were definitely diagnosed with specific pathogen.Among them, 73.46% were caused by enteroviruse, 15.17% were caused by EB virus, and 5.21% were caused by Japanese encephalitis virus. Conclusion The incidence peak of viral encephalitis was in spring and summer, the high risk and high fatality rate population were those in the age group under 15 years old. It is necessary to set up sentinel surveillance system especially focus on cases under 15 years old to understand the burden of disease and pathogenic spectrum of viral encephalitis in Guangdong province.