2008—2017年云南省手足口病流行特征及主要病原学分析
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摘要
目的分析云南省手足口病动态流行特征,为制订有效防控措施提供依据。方法用描述性流行病学方法分析云南省10年疫情和病原检测资料。结果 10年来,该病发病率总体呈上升趋势并呈现出隔年高发的特点;每年4、5、6月出现发病高峰,10月后手足口疫情会有"翘尾"的现象;玉溪、昆明、红河等地是本省手足口病高发地区;病例以散居儿童和幼托儿童为主,散居儿童病例构成呈逐年上升的趋势,而幼托儿童和学生稳中有降;其它肠道病毒所占比例呈逐年上升的趋势。结论 2008—2017年云南省手足口病发病存在明显的季节性、地区聚集性和人群分布特点,病原谱也有所变化,相关部门要加强该病的监测和防控。
Objective To analyze the dynamic epidemiological characteristics of hand-foot-mouth disease(HFMD)in Yunnan Province so as to offer the effective measures of prevention and control.MethodsThe descriptive epidemiologi-cal methods were used to analyze the epidemic situation and pathogen detection data of HFMD in Yunnan Province from2008 to 2017.ResultsDuring the past ten years, the incidence of the disease presented an uptrend. It had the characteris-tics of high prevalence in alternate year. The peak incidence occurred in April, May and June each year. After October, theepidemic of HFMD had a phenomenon of"tail lift". Yuxi, Kunming and Honghe places were high incidence areas of HFMDin this province. The HFMD cases were mainly scattered children and childcare children, and the composition of scatteredchildren was increasing year by year, while the childcare and student children were steadily falling. The proportion of otherenteroviruses was increasing year by year.ConclusionFrom 2008 to 2017, the incidence of HFMD in Yunnan Provincehas obvious seasonal, regional agglomeration and population distribution characteristics, and the pathogen spectrum has alsochanged. The relevant departments should strengthen the monitoring, prevention and control of the disease.
Objective To analyze the dynamic epidemiological characteristics of hand-foot-mouth disease(HFMD)in Yunnan Province so as to offer the effective measures of prevention and control.MethodsThe descriptive epidemiologi-cal methods were used to analyze the epidemic situation and pathogen detection data of HFMD in Yunnan Province from2008 to 2017.ResultsDuring the past ten years, the incidence of the disease presented an uptrend. It had the characteris-tics of high prevalence in alternate year. The peak incidence occurred in April, May and June each year. After October, theepidemic of HFMD had a phenomenon of"tail lift". Yuxi, Kunming and Honghe places were high incidence areas of HFMDin this province. The HFMD cases were mainly scattered children and childcare children, and the composition of scatteredchildren was increasing year by year, while the childcare and student children were steadily falling. The proportion of otherenteroviruses was increasing year by year.ConclusionFrom 2008 to 2017, the incidence of HFMD in Yunnan Provincehas obvious seasonal, regional agglomeration and population distribution characteristics, and the pathogen spectrum has alsochanged. The relevant departments should strengthen the monitoring, prevention and control of the disease.
引文
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[2] Tan X,Huang X,Zhu S,et al.The persistent circulation of enterovirus71 in People’s Republic of China:causing emerging nationwide epidemics since 2008[J]. PLos One,2011,6(9):e25662.
[3]肖革新,胡跃华,马家奇,等.中国2008-2011年手足口病空间聚集性及变化趋势研究[J].中华流行病学杂志,2012,33(8):808-812.
[4]于石成,周征奇,杨芳,等.中国2008-2013年度重症手足口病的时空聚集性及其变化趋势分析[J].中华流行病学杂志,2014,35(3):271-274.
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[8]戴德宝,朱罗松.武汉市江岸区2008-2011年手足口病疫情分析[J].公共卫生与预防医学,2012,23(5):89-90.
[9]沈红,陈洪波,刘景壹.徐汇区2005-2009年手足口病疫情特征和病原学监测[J].现代预防医学,2011,38(10):1949-1950,1958.
[10]韩江涛,刘立,彭伟,等.应用地理信息系统对石家庄市手足口病时空特征的分析[J].中华传染病杂志,2012,30(11):652-655.
[11] Park SK,Park B,Ki M,et al.Transmission of seasonal outbreak of childhood enteroviral aseptic meningitis and hand-foot-mouth disease[J]. J Korean Med Sci,2010,25:677-683.
[12]尹洁,吴强,杨汝松,等.云南省手足口病高发区健康人群EV71lgG抗体水平分析[J].中华实验和临床病毒学杂志,2015,29(6):502-504.
[13]韩江涛,彭伟,刘立,等.石家庄市2009_2012年手足口病病原学特征及变化规律分析[J].中国全科医学,2014,17(35):4213-4216.
[14]常昭瑞,张静,孙军玲,等.中国2008-2009年手足口病报告病例流行病学特征分析[J].中华流行病学杂志,2011,32(7):676-680.
[15] Hosoya M,Kawasaki Y,Sato M,et al.Genetic diversity of coxsackievirus A16 Associated with hand,foot,and mouth disease epidemics in Japan from 1983 to 2003[J]. J Clin Mierobiol,2007,45(1):112-120.
[16] Li L,He Y,Yang H,et al.Genetic characteristics of human enterovirus71 and coxsackievirus A16 circulating from 1999 to 2004 in Shenzhen,People's Republic of China[J]. J Clin Microbiol,2005,43(8):3835-3839.
[17] Ang LW,Koh BK,Chan KP,et al. Epidemiology and control of hand,foot and mouth disease in Singapore,2001-2007[J]. Ann Acad Med Singapore,2009,38(2):106-112.
[18] Tseng FC,Huang HC,Chi CY,et al.Epidemiological survey of enterovirus infections occurring in Taiwan between 2000 and 2005:analysis of sentinel physician surveillance data[J]. JMed Virol,2007,79(12):1850-1860.
[19]陈炜,翁育伟,何文祥,等.福建省2011-2014年手足口病相关病原柯萨奇病毒A组10型的分子流行病学研究[J].中华流行病学杂志,2016,37(4):563-567.
[20] Fujimoto Y,lizuka S,Enomoto M,et al.Hand,foot,and mouth disease caused by coxsackievirus A6,Japan,2011[J]. Emerg Infect Dis,2012,18(2):337-339.
[21] Martinez AA,Castillo J,Sanchez MC,et al.Molecular diagnosis of echovirus 30 as the etiological agent in an outbreak of aseptic meningitis in Panama:May-June 2008[J]. J Infect Dev Ctries,2012,6(12):836-841.
[2] Tan X,Huang X,Zhu S,et al.The persistent circulation of enterovirus71 in People’s Republic of China:causing emerging nationwide epidemics since 2008[J]. PLos One,2011,6(9):e25662.
[3]肖革新,胡跃华,马家奇,等.中国2008-2011年手足口病空间聚集性及变化趋势研究[J].中华流行病学杂志,2012,33(8):808-812.
[4]于石成,周征奇,杨芳,等.中国2008-2013年度重症手足口病的时空聚集性及其变化趋势分析[J].中华流行病学杂志,2014,35(3):271-274.
[5]陈琦,邢学森,吴杨,等.湖北省2009-2015年手足口病流行病学和病原学分析[J].中华流行病学杂志,2017,38(4):441-445.
[6] Urashima M,Shindo N,Okabe N. Seasonal models of herpangina and hand-foot-mouth disease to simulate annual fluctuations in urban warming in Tokyo[J]. Jpn J Infect Dis,2003,56(2):48-53.
[7]沈逸雄,黄振宇,熊劲光.2009-2012年东莞市手足口病疫情分析[J].预防医学情报杂志.2014,30(11):926-929.
[8]戴德宝,朱罗松.武汉市江岸区2008-2011年手足口病疫情分析[J].公共卫生与预防医学,2012,23(5):89-90.
[9]沈红,陈洪波,刘景壹.徐汇区2005-2009年手足口病疫情特征和病原学监测[J].现代预防医学,2011,38(10):1949-1950,1958.
[10]韩江涛,刘立,彭伟,等.应用地理信息系统对石家庄市手足口病时空特征的分析[J].中华传染病杂志,2012,30(11):652-655.
[11] Park SK,Park B,Ki M,et al.Transmission of seasonal outbreak of childhood enteroviral aseptic meningitis and hand-foot-mouth disease[J]. J Korean Med Sci,2010,25:677-683.
[12]尹洁,吴强,杨汝松,等.云南省手足口病高发区健康人群EV71lgG抗体水平分析[J].中华实验和临床病毒学杂志,2015,29(6):502-504.
[13]韩江涛,彭伟,刘立,等.石家庄市2009_2012年手足口病病原学特征及变化规律分析[J].中国全科医学,2014,17(35):4213-4216.
[14]常昭瑞,张静,孙军玲,等.中国2008-2009年手足口病报告病例流行病学特征分析[J].中华流行病学杂志,2011,32(7):676-680.
[15] Hosoya M,Kawasaki Y,Sato M,et al.Genetic diversity of coxsackievirus A16 Associated with hand,foot,and mouth disease epidemics in Japan from 1983 to 2003[J]. J Clin Mierobiol,2007,45(1):112-120.
[16] Li L,He Y,Yang H,et al.Genetic characteristics of human enterovirus71 and coxsackievirus A16 circulating from 1999 to 2004 in Shenzhen,People's Republic of China[J]. J Clin Microbiol,2005,43(8):3835-3839.
[17] Ang LW,Koh BK,Chan KP,et al. Epidemiology and control of hand,foot and mouth disease in Singapore,2001-2007[J]. Ann Acad Med Singapore,2009,38(2):106-112.
[18] Tseng FC,Huang HC,Chi CY,et al.Epidemiological survey of enterovirus infections occurring in Taiwan between 2000 and 2005:analysis of sentinel physician surveillance data[J]. JMed Virol,2007,79(12):1850-1860.
[19]陈炜,翁育伟,何文祥,等.福建省2011-2014年手足口病相关病原柯萨奇病毒A组10型的分子流行病学研究[J].中华流行病学杂志,2016,37(4):563-567.
[20] Fujimoto Y,lizuka S,Enomoto M,et al.Hand,foot,and mouth disease caused by coxsackievirus A6,Japan,2011[J]. Emerg Infect Dis,2012,18(2):337-339.
[21] Martinez AA,Castillo J,Sanchez MC,et al.Molecular diagnosis of echovirus 30 as the etiological agent in an outbreak of aseptic meningitis in Panama:May-June 2008[J]. J Infect Dev Ctries,2012,6(12):836-841.