2011-2016年合肥市手足口病多次感染状况及流行病学特征分析
|
摘要
目的探讨合肥市手足口病(hand,foot and mouth disease,HFMD)多次感染状况及其流行特征,为其防控提供科学依据。方法整理"传染病报告信息管理系统"中现住址为合肥市的HFMD个案,筛选出多次感染的病例,采用描述性流行病学方法进行分析。结果 2011-2016年合肥市HFMD再感染发病率为10.73/10万,多次感染发生率为5.12%。83.36%的再次感染发生在上一次感染后两年内。单次感染和多次感染首次发病年龄中位数分别为2.30岁和1.94岁,差异有统计学意义(Z=-28.84,P<0.001)。0~岁组儿童多次感染发生率(8.15%)最高,<6岁儿童随着年龄的增长多次感染发生率逐渐下降(X_(趋势)~2=609.28,P<0.001)。男童更容易发生多次感染,再感染病例幼托儿童构成比高。HFMD发病率高的地区再感染发病率也高。结论合肥市HFMD多次感染疫情比较严重,需重点关注首次发病年龄小于3岁的男童、幼托儿童等人群及发病率高的地区,采取有针对性的防控措施。
Objective To explore the multiple infection status of hand,foot and mouth disease( HFMD) and its epidemiological characteristics in Hefei City to provide scientific evidence for HFMD prevention and control. Methods The cases of multiple infection of HFMD living in Hefei were screened out from National Notifiable Disease Report System and analyzed by descriptive epidemiology. Results The incidence of reinfection of HFMD in Hefei from 2011 to 2016 was 10. 73 per 100 000,and the incidence of multiple infections was 5. 12%. 83. 36% of the reinfection occurred within two years of the last infection. The median age of first infection among multiple infections was 1. 94 years old and single infection cases was 2. 30 years old,there was significant difference( Z =-28. 84,P < 0. 001). The incidence of multiple infections in the 0-year-old group was the highest( 8. 15%),and the incidence of multiple infections decreased with age in children less than 6 years old( X_(trend)~2= 609. 28,P < 0. 001). Boys were more susceptible to multiple infections,and reinfection cases were mainly occurred by the children in kindergarten. The incidence of reinfection was also high in areas with high incidence of HFMD. Conclusions Multiple infections of HFMD is a serious common health threat to children in Hefei. We should pay more attention to the population including boys with a first onset age less than three years old,kindergarten children as well as children from areas with high incidence and take prevention and control measures.
Objective To explore the multiple infection status of hand,foot and mouth disease( HFMD) and its epidemiological characteristics in Hefei City to provide scientific evidence for HFMD prevention and control. Methods The cases of multiple infection of HFMD living in Hefei were screened out from National Notifiable Disease Report System and analyzed by descriptive epidemiology. Results The incidence of reinfection of HFMD in Hefei from 2011 to 2016 was 10. 73 per 100 000,and the incidence of multiple infections was 5. 12%. 83. 36% of the reinfection occurred within two years of the last infection. The median age of first infection among multiple infections was 1. 94 years old and single infection cases was 2. 30 years old,there was significant difference( Z =-28. 84,P < 0. 001). The incidence of multiple infections in the 0-year-old group was the highest( 8. 15%),and the incidence of multiple infections decreased with age in children less than 6 years old( X_(trend)~2= 609. 28,P < 0. 001). Boys were more susceptible to multiple infections,and reinfection cases were mainly occurred by the children in kindergarten. The incidence of reinfection was also high in areas with high incidence of HFMD. Conclusions Multiple infections of HFMD is a serious common health threat to children in Hefei. We should pay more attention to the population including boys with a first onset age less than three years old,kindergarten children as well as children from areas with high incidence and take prevention and control measures.
引文
[1]中华人民共和国卫生部.手足口病预防控制指南(2009版)[EB/OL].(2009-06-04)[2017-06-05].http://www.gov.cn/gzdt/2009-06/04/content_1332078.htm.
[2]中华人民共和国卫生部.手足口病诊疗指南(2010年版)[EB/OL].(2010-04-21)[2017-06-05].http://www.nhfpc.gov.cn/mohyzs/s3586/201004/46884.shtml.
[3]Li P,Li T,Gu Q,et al.Children’s caregivers and public playgrounds:potential peservoirs of infection of hand-foot-and-mouth disease[J].Sci Rep,2016,6:36375.
[4]Ang LY,Too HK,Tan EL,et al.Antiviral activity of Lactobacillus reuteriprotectis against coxsackievirus A and enterovirus 71 infection in human skeletal muscle and colon cell lines[J].Virol J,2016,13:111.
[5]耿兴义,常彩云,许华茹,等.济南市手足口病单次与多次感染病例流行病学对比分析[J].中国病原生物学杂志,2012,7(12):927-929.
[6]陈小慧,徐军强,邢学森,等.襄阳市2009-2013年手足口病再次罹患病例流行病学特征[J].公共卫生与预防医学,2015,26(4):92-94.
[7]吴一峰,周逸夫,韩丽媛,等.宁波市江北区2012-2014年手足口病重复发病率及其影响因素[J].中国感染控制杂志,2016,15(4):227-233.
[8]谢忠杭,王灵岚,严延生,等.福建省4岁以下儿童手足口病再次罹患特征的队列分析[J].中华流行病学杂志,2014,35(10):1109-1114.
[9]徐胜平,喻同琦,彭公德,等.湖北麻城市2008-2012年手足口病重复感染流行病学特征分析[J].公共卫生与预防医学,2013,24(4):94-95.
[10]Tian H,Zhang Y,Shi Y,et al.Epidemiological and aetiological characteristics of hand,foot,and mouth disease in Shijiazhuang City,Hebei Province,China,2009-2012[J].PLo S One,2017,12(5):e0176604.
[11]Xu M,Yu W,Tong S,et al.Non-linear association between exposure to ambient temperature and children’s hand-foot-and-mouth disease in Beijing,China[J].PLo S One,2014,10(5):e0126171.
[12]胡青坡,孙乔,何纳,等.上海市浦东新区手足口病单次与重复感染病例流行病学特征分析[J].中华疾病控制杂志,2014,18(4):363-365.
[13]刘莹莹,于秋丽,苏通,等.2011-2015年河北省手足口病流行特征及病原特征分析[J].中华疾病控制杂志,2017,21(2):151-155.
[14]Zhang D,Chen Y,Chen X,et al.Enterovirus 71 neutralizing antibodies seroepidemiologicalresearch among children in Guangzhou,China between 2014 and 2015:across-sectional study[J].Int J Environ Res Public Health,2017,14(3):319.
[15]颜玉炳,郑惠能,苏成豪.幼托机构手足口病暴发疫情后儿童隐形感染情况[J].中国学校卫生,2016,37(2):250-252.
[16]查文婷,王玲,郑剑,等.基于GIS技术分析长沙市2006-2013年手足口病流行病学特征分析[J].中华疾病控制杂志,2017,21(4):345-348.
[17]蒋丽娜,谭毅,王晶,等.2008-2015年广西手足口病流行病学特征及时空聚集性分析[J].中华疾病控制杂志,2017,21(4):340-344.
[18]Sham NM,Krishnarajah I,Ibrahim NA,et al.Temporal and spatial mapping of hand,foot and mouth disease in Sarawak,Malaysia[J].Geospat Health,2014,8(2):503-507.
[2]中华人民共和国卫生部.手足口病诊疗指南(2010年版)[EB/OL].(2010-04-21)[2017-06-05].http://www.nhfpc.gov.cn/mohyzs/s3586/201004/46884.shtml.
[3]Li P,Li T,Gu Q,et al.Children’s caregivers and public playgrounds:potential peservoirs of infection of hand-foot-and-mouth disease[J].Sci Rep,2016,6:36375.
[4]Ang LY,Too HK,Tan EL,et al.Antiviral activity of Lactobacillus reuteriprotectis against coxsackievirus A and enterovirus 71 infection in human skeletal muscle and colon cell lines[J].Virol J,2016,13:111.
[5]耿兴义,常彩云,许华茹,等.济南市手足口病单次与多次感染病例流行病学对比分析[J].中国病原生物学杂志,2012,7(12):927-929.
[6]陈小慧,徐军强,邢学森,等.襄阳市2009-2013年手足口病再次罹患病例流行病学特征[J].公共卫生与预防医学,2015,26(4):92-94.
[7]吴一峰,周逸夫,韩丽媛,等.宁波市江北区2012-2014年手足口病重复发病率及其影响因素[J].中国感染控制杂志,2016,15(4):227-233.
[8]谢忠杭,王灵岚,严延生,等.福建省4岁以下儿童手足口病再次罹患特征的队列分析[J].中华流行病学杂志,2014,35(10):1109-1114.
[9]徐胜平,喻同琦,彭公德,等.湖北麻城市2008-2012年手足口病重复感染流行病学特征分析[J].公共卫生与预防医学,2013,24(4):94-95.
[10]Tian H,Zhang Y,Shi Y,et al.Epidemiological and aetiological characteristics of hand,foot,and mouth disease in Shijiazhuang City,Hebei Province,China,2009-2012[J].PLo S One,2017,12(5):e0176604.
[11]Xu M,Yu W,Tong S,et al.Non-linear association between exposure to ambient temperature and children’s hand-foot-and-mouth disease in Beijing,China[J].PLo S One,2014,10(5):e0126171.
[12]胡青坡,孙乔,何纳,等.上海市浦东新区手足口病单次与重复感染病例流行病学特征分析[J].中华疾病控制杂志,2014,18(4):363-365.
[13]刘莹莹,于秋丽,苏通,等.2011-2015年河北省手足口病流行特征及病原特征分析[J].中华疾病控制杂志,2017,21(2):151-155.
[14]Zhang D,Chen Y,Chen X,et al.Enterovirus 71 neutralizing antibodies seroepidemiologicalresearch among children in Guangzhou,China between 2014 and 2015:across-sectional study[J].Int J Environ Res Public Health,2017,14(3):319.
[15]颜玉炳,郑惠能,苏成豪.幼托机构手足口病暴发疫情后儿童隐形感染情况[J].中国学校卫生,2016,37(2):250-252.
[16]查文婷,王玲,郑剑,等.基于GIS技术分析长沙市2006-2013年手足口病流行病学特征分析[J].中华疾病控制杂志,2017,21(4):345-348.
[17]蒋丽娜,谭毅,王晶,等.2008-2015年广西手足口病流行病学特征及时空聚集性分析[J].中华疾病控制杂志,2017,21(4):340-344.
[18]Sham NM,Krishnarajah I,Ibrahim NA,et al.Temporal and spatial mapping of hand,foot and mouth disease in Sarawak,Malaysia[J].Geospat Health,2014,8(2):503-507.