蚌埠市2008—2016年手足口病流行特征分析
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摘要
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(χ~2=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(χ~2=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。
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( χ~2= 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( χ~2= 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.
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( χ~2= 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( χ~2= 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.
引文
[1]张进,史永林,吴家兵,等.安徽省2008—2012年手足口病流行病学及病原学特征分析[J].中华疾病控制杂志,2014,18(6):497-500.
[2]吴晓芳,纪蕾,徐德顺,等.2008—2010年湖州市手足口病病原监测分析[J].中国卫生检验杂志,2012,22(4):837-838.
[3]刘永孝.安徽省2008—2009年手足口病流行特征分析[J].中华疾病控制杂志,2012,16(3):237-240.
[4]陈国平,史永林,张进,等.安徽省2008—2014年手足口病流行特征分析[J].现代预防医学杂志,2016,43(4):588-590.
[5]安徽省卫生和计划生育委员会.安徽省法定传染病疫情概况[EB/QL].(2017-04-05)[2017-03-17].http://www.ahwjw.gov.cn/wjw/xwfb/xwfb/201703/41f78b90bac047e4869b1680e85c879c.html.
[6]国家卫生和计划生育委员会.全国法定传染病疫情概况[EB/QL].(2017-04-05)[2017-02-23].http://www.nhfpc.gov.cn/jkj/s3578/201702/38ca5990f8a54ddf9ca6308fec406157.shtml.
[7]Xing W,Liao Q,Viboud C,et al.Hand,foot,and mouth disease in China,2008—12,an epidemiological study[J].Lancet Infect Dis,2014,14(4):308-318.
[8]田晓灵,郭卫东,姜晓峰,等.2008—2011年内蒙古自治区手足口病流行特征分析[J].疾病监测,2013,28(11):901-904.
[9]钱海坤,田祎,李锡泰,等.2007—2012年北京市手足口病流行病学研究[J].国际病毒学杂志,2013,20(1):6-10.
[10]王伶,于伟,张倩,等.2013年辽宁省手足口病病原监测结果分析[J].中国预防医学杂志,2015,16(8):591-594.
[11]Li T,Yang Z,Liu X,et al.Hand,foot,and mouth disease epide-miological status and relationship with meteorological variables in Guangzhou,southern China,2008—2012[J].Rev Inst Med Trop Sao Paulo,2014,56(6):533-539.
[12]Huang Y,Deng T,Yu S,et al.Effect of meteorological variables on the incidence of hand,foot,and mouth disease inchildren:atimeseries analysis in Guangzhou,China[J]BMC Infect Dis,2013,16(13):133-135.
[13]龙道庆,迟艳梅,王智化,等.宣城市宣州区2009—2013年手足口病流行特征分析[J].中华疾病控制杂志,2015,19(10):995-998.
[14]蔡永彬,嵇红.2012—2014年太仓市手足口病流行病学和病原学特征[J].江苏预防医学,2016,27(2):198-200.
[15]吴楠,段永翔,王颖,等.2012—2014年深圳市南山区手足口病流行病学和病原学分析[J].热带医学杂志,2015,15(5):684-686.
[16]刘丹,苏豪浩,吴建红,等.手足口病重症病例的流行特征及危险因素[J].实用医学杂志,2013,29(6):995-998.
[17]刘磊,吕强,陈萍,等.成都市重症手足口病的危险因素分析[J].现代预防医学,2016,43(6):1110-1113.
[18]Misbra C,Lain A,Prakash O,et al.Molecular Characterization of Dengue Viruses Circulating During 2009-2012 in Uttar Pradesh,India[J].J Med Virol,2015,87(1):68-75.
[19]李燕,汪东篱,姚炜,等.深圳市光明新区2014年手足口病病原监测结果分析[J].中国卫生检验杂志,2015,25(21):3728-3730.
[2]吴晓芳,纪蕾,徐德顺,等.2008—2010年湖州市手足口病病原监测分析[J].中国卫生检验杂志,2012,22(4):837-838.
[3]刘永孝.安徽省2008—2009年手足口病流行特征分析[J].中华疾病控制杂志,2012,16(3):237-240.
[4]陈国平,史永林,张进,等.安徽省2008—2014年手足口病流行特征分析[J].现代预防医学杂志,2016,43(4):588-590.
[5]安徽省卫生和计划生育委员会.安徽省法定传染病疫情概况[EB/QL].(2017-04-05)[2017-03-17].http://www.ahwjw.gov.cn/wjw/xwfb/xwfb/201703/41f78b90bac047e4869b1680e85c879c.html.
[6]国家卫生和计划生育委员会.全国法定传染病疫情概况[EB/QL].(2017-04-05)[2017-02-23].http://www.nhfpc.gov.cn/jkj/s3578/201702/38ca5990f8a54ddf9ca6308fec406157.shtml.
[7]Xing W,Liao Q,Viboud C,et al.Hand,foot,and mouth disease in China,2008—12,an epidemiological study[J].Lancet Infect Dis,2014,14(4):308-318.
[8]田晓灵,郭卫东,姜晓峰,等.2008—2011年内蒙古自治区手足口病流行特征分析[J].疾病监测,2013,28(11):901-904.
[9]钱海坤,田祎,李锡泰,等.2007—2012年北京市手足口病流行病学研究[J].国际病毒学杂志,2013,20(1):6-10.
[10]王伶,于伟,张倩,等.2013年辽宁省手足口病病原监测结果分析[J].中国预防医学杂志,2015,16(8):591-594.
[11]Li T,Yang Z,Liu X,et al.Hand,foot,and mouth disease epide-miological status and relationship with meteorological variables in Guangzhou,southern China,2008—2012[J].Rev Inst Med Trop Sao Paulo,2014,56(6):533-539.
[12]Huang Y,Deng T,Yu S,et al.Effect of meteorological variables on the incidence of hand,foot,and mouth disease inchildren:atimeseries analysis in Guangzhou,China[J]BMC Infect Dis,2013,16(13):133-135.
[13]龙道庆,迟艳梅,王智化,等.宣城市宣州区2009—2013年手足口病流行特征分析[J].中华疾病控制杂志,2015,19(10):995-998.
[14]蔡永彬,嵇红.2012—2014年太仓市手足口病流行病学和病原学特征[J].江苏预防医学,2016,27(2):198-200.
[15]吴楠,段永翔,王颖,等.2012—2014年深圳市南山区手足口病流行病学和病原学分析[J].热带医学杂志,2015,15(5):684-686.
[16]刘丹,苏豪浩,吴建红,等.手足口病重症病例的流行特征及危险因素[J].实用医学杂志,2013,29(6):995-998.
[17]刘磊,吕强,陈萍,等.成都市重症手足口病的危险因素分析[J].现代预防医学,2016,43(6):1110-1113.
[18]Misbra C,Lain A,Prakash O,et al.Molecular Characterization of Dengue Viruses Circulating During 2009-2012 in Uttar Pradesh,India[J].J Med Virol,2015,87(1):68-75.
[19]李燕,汪东篱,姚炜,等.深圳市光明新区2014年手足口病病原监测结果分析[J].中国卫生检验杂志,2015,25(21):3728-3730.