2009-2017年北京市通州区手足口病流行病学特征及病原监测分析
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摘要
目的分析2009—2017年北京市通州区手足口病流行特征及病原学结果,为制定防控策略提供依据。方法收集通州区近9年的手足口病报告资料,采用描述流行病学方法对手足口病流行病学及病原资料进行分析。结果 9年间通州区报告手足口病病例29 809例,年均发病率为276.04/10万,呈下降趋势,病例数隔年高发,5—7月为发病高峰。西部和北部地区年均发病率高,前3位为马驹桥镇、梨园镇和张家湾镇。男女性别比为1.45∶1,集中在≤5岁年龄组,占91.23%。2010年重症病例比例最高,达0.54%,随后逐年下降(χ~2=–6.864,P<0.001)。历年病原谱构成不同(χ~2=285.149,P<0.001),优势毒株呈季节性变化。结论通州区手足口病发病率和重症比例呈下降趋势,有季节性、≤5岁儿童和重点地区高发的分布特征,病原分布呈不同年份和季节的动态变化。应进一步加强疫情监测和宣传教育力度,做好病原学检测,流行季节对重点地区、重点人群采取有效的综合性防控措施。
Objective To analyze the epidemiological and etiological characteristics of hand foot and mouth disease(HFMD) in Tongzhou district of Beijing from 2009 to 2017 and provide evidence for the prevention and control of HFMD.Methods Data of hand foot and mouth disease(HFMD) reports in Tongzhou district in recent 9 years were collected,and descriptive epidemiological methods were used to analyze the epidemiological and pathogenic data of HFMD.Results During the 9 years,29 809 cases of HFMD disease were reported in Tongzhou district,with an average annual incidence of276.04/100 000,showing a downward trend,the number of cases was high every other year.The incidence peak was from May-July.The western and northern regions have a high average annual incidence,and the top three are Majuqiao town,Liyuan town and Zhangjiawan town.The sex ratio of males and females was 1.45∶1,the cases were concentrated in the age group of 5 years old,accounting for 91.23%.In 2010,the highest proportion of serious illness case of illness,reaches 0.54%,then gradually decreased(χ~2=–6.864,P<0.001).The composition of pathogens over the years is different(χ~2=285.149,P<0.001),and the dominant strains are seasonally changing.Conclusion The incidence and proportion of severe cases of HFMD showed decline trends in Tongzhou district,and the seasonal,age and area distributions of the cases were observed.The predominant pathogens varied with season and year.It is necessary to further strengthen HFMD surveillance,health education and etiological detection.Effective comprehensive HFMD prevention and control measures should be taken in key season,area and population during the epidemic season.
Objective To analyze the epidemiological and etiological characteristics of hand foot and mouth disease(HFMD) in Tongzhou district of Beijing from 2009 to 2017 and provide evidence for the prevention and control of HFMD.Methods Data of hand foot and mouth disease(HFMD) reports in Tongzhou district in recent 9 years were collected,and descriptive epidemiological methods were used to analyze the epidemiological and pathogenic data of HFMD.Results During the 9 years,29 809 cases of HFMD disease were reported in Tongzhou district,with an average annual incidence of276.04/100 000,showing a downward trend,the number of cases was high every other year.The incidence peak was from May-July.The western and northern regions have a high average annual incidence,and the top three are Majuqiao town,Liyuan town and Zhangjiawan town.The sex ratio of males and females was 1.45∶1,the cases were concentrated in the age group of 5 years old,accounting for 91.23%.In 2010,the highest proportion of serious illness case of illness,reaches 0.54%,then gradually decreased(χ~2=–6.864,P<0.001).The composition of pathogens over the years is different(χ~2=285.149,P<0.001),and the dominant strains are seasonally changing.Conclusion The incidence and proportion of severe cases of HFMD showed decline trends in Tongzhou district,and the seasonal,age and area distributions of the cases were observed.The predominant pathogens varied with season and year.It is necessary to further strengthen HFMD surveillance,health education and etiological detection.Effective comprehensive HFMD prevention and control measures should be taken in key season,area and population during the epidemic season.
引文
[1]卫生部办公厅.手足口病诊疗指南(2008版)[EB/OL].(2008-11-19)[2018-05-10].http://www.nhfpc.gov.cn/yzygj/s3585u/200812/c0434749a3214ffd863905f98aba780f.shtml.Ministry of Health.Hand,foot and mouth disease diagnosis and treatment guidelines(2008 edition)[EB/OL].(2008-11-19)[2018-05-10].http://www.nhfpc.gov.cn/yzygj/s3585u/200812/c0434749a3214ffd863905f98aba780f.shtml.
[2]卫生部办公厅.手足口病诊疗指南(2010版)[EB/OL].(2010-04-20)[2018-05-10].http://www.nhfpc.gov.cn/yzygj/s3593g/201306/6d935c0f43cd4a1fb46f8f71acf8e245.shtml.Ministry of Health.Hand-foot-mouth disease diagnosis and treatment guidelines(2010 edition)[EB/OL].(2010-04-20)[2018-05-10].http://www.nhfpc.gov.cn/yzygj/s3593g/201306/6d935c0f43cd4a1fb46f8f71acf8e245.shtml.
[3]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.DOI:10.16462/j.cnki.zhjbkz.2017.04.005.Jiang LN,Tan Y,Wang J,et al.Epidemiological characteristics and temporal-spatial clustering of hand,foot and mouth disease in Guangxi from 2008 to 2015[J].Chin J Dis Control Prev,2017,21(4):340-344.DOI:10.16462/j.cnki.zhjbkz.2017.04.005.
[4]于晓楠,忻丽菁,杨吉星,等.2010-2016年上海市虹口区手足口流行病学及病原学特征分析[J].中国预防医学杂志,2018,19(1):58-63.DOI:10.16506/j.1009-6639.2018.01.014.Yu XN,Xin LJ,Yang JX,et al.Epidemiological and etiological features of hand,foot and mouth disease in Hongkou district ofShanghai,2010-2016[J].Chin Prev Med,2018,19(1):58-63.DOI:10.16506/j.1009-6639.2018.01.014.
[5]李锡太,陈艳伟,何战英,等.北京市2007-2015年手足口病时间分布特征分析[J].国际病毒学杂志,2016,23(3):145-147.DOI:10.3760/cma.j.issn.1673-4092.2016.03.001.Li XT,Chen YW,He ZY,et al.Analysis on the seasonality of hand,foot and mouth disease in Beijing from 2007 to 2015[J].Int J Virol,2016,23(3):145-147.DOI:10.3760/cma.j.issn.1673-4092.2016.03.001.
[6]胡跃华,廖家强,冯国双,等.自回归移动平均模型在全国手足口病疫情预测中的应用[J].疾病监测,2014,29(10):827-832.DOI:10.3784/j.issn.1003-9961.2014.10.018.Hu YH,Liao JQ,Feng GS,et al.Application of multiple seasonal autoregressive integrated moving average model in prediction of incidence of hand,foot and mouth disease in China[J].Dis Surveill,2014,29(10):827-832.DOI:10.3784/j.issn.1003-9961.2014.10.018.
[7]刘宏灵,刘莹莹,于秋丽,等.2011-2014年河北省手足口病流行特征及病原特征分析[J].现代预防医学,2016,43(13):2315-2319.DOI:10.16462/j.cnki.zhjbkz.2017.02.011.Liu HL,Liu YY,Yu QL,et al.Epidemiology and etiology of hand,foot and mouth disease in Hebei province,2011-2014[J].Mod Prev Med,2016,43(13):2315-2319.DOI:10.16462/j.cnki.zhjbkz.2017.02.011.
[8]陈国平,史永林,张进,等.2008-2014年安徽省手足口病流行特征分析[J].现代预防医学,2016,43(4):588-590,630.Chen GP,Shi YL,Zhang J,et al.Analysis of the epidemiological characteristics of hand,foot and mouth disease in Anhui province between 2008 and 2014[J].Mod Prev Med,2016,43(4):588-590,630.
[9]Chen KT,Chang HL,Wang ST,et al.Epidemiologic features of hand,foot adn mouth disease and herpangina caused by enterovirus71 in Taiwan,1998-2005[J].Pediatrics,2007,120(2):e244-e252.DOI:10.1542/peds.2006-3331.
[10]彭瑞吟,甘露,彭清琴,等.2010-2014年深圳市宝安区手足口病流行特征研究[J].现代预防医学,2016,43(8):1377-1380.Peng RY,Gan L,Peng QQ,et al.Analysis on epidemiological characteristics of hand,foot and mouth disease in Bao′an district of Shenzhen from 2010 to 2014[J].Mod Prev Med,2016,43(8):1377-1380.
[11]国家卫生健康委员会办公厅.手足口病诊疗指南(2018年版)[EB/OL].(2018-05-15)[2018-05-20].http://www.nhc.gov.cn/yzygj/s3594q/201805/5db274d8697a41ea84e88eedd8bf8f63.shtml.National Health Commission of People′s Republic of China.Hand,foot and mouth disease diagnosis and treatment guidelines(2018edition)[EB/OL].(2018-05-15)[2018-05-20].http://www.nhc.gov.cn/yzygj/s3594q/201805/5db274d8697a41ea84e88eedd8bf8f63.shtml.
[12]王永军.新生儿手足口病一例[J].中国新生儿科杂志,2014,29(1):66.DOI:10.3969/j.issn.1673-6710.2014.01.020.Wang YJ.One neonatal case of hand,foot and mouth disease[J].Chin J Neonatol,2014,29(1):66.DOI:10.3969/j.issn.1673-6710.2014.01.020.
[13]但蓓蓓.新生儿手足口病一例[J].临床误诊误治,2016,29(6):23.Dan BB.One neonatal case of hand,foot and mouth disease[J].Clin Misdiagnios Misth,2016,29(6):23.
[14]占华剑,柯昌文.全球手足口病流行现状及分子流行病学研究进展[J].华南预防医学,2011,37(5):34-38,41.Zhan HJ,Ke CW.The global present epidemic situation and research progress of molecular epidemiology of hand,foot and mouth disease[J].South China J Prev Med,2011,37(5):34-38,41.
[2]卫生部办公厅.手足口病诊疗指南(2010版)[EB/OL].(2010-04-20)[2018-05-10].http://www.nhfpc.gov.cn/yzygj/s3593g/201306/6d935c0f43cd4a1fb46f8f71acf8e245.shtml.Ministry of Health.Hand-foot-mouth disease diagnosis and treatment guidelines(2010 edition)[EB/OL].(2010-04-20)[2018-05-10].http://www.nhfpc.gov.cn/yzygj/s3593g/201306/6d935c0f43cd4a1fb46f8f71acf8e245.shtml.
[3]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.DOI:10.16462/j.cnki.zhjbkz.2017.04.005.Jiang LN,Tan Y,Wang J,et al.Epidemiological characteristics and temporal-spatial clustering of hand,foot and mouth disease in Guangxi from 2008 to 2015[J].Chin J Dis Control Prev,2017,21(4):340-344.DOI:10.16462/j.cnki.zhjbkz.2017.04.005.
[4]于晓楠,忻丽菁,杨吉星,等.2010-2016年上海市虹口区手足口流行病学及病原学特征分析[J].中国预防医学杂志,2018,19(1):58-63.DOI:10.16506/j.1009-6639.2018.01.014.Yu XN,Xin LJ,Yang JX,et al.Epidemiological and etiological features of hand,foot and mouth disease in Hongkou district ofShanghai,2010-2016[J].Chin Prev Med,2018,19(1):58-63.DOI:10.16506/j.1009-6639.2018.01.014.
[5]李锡太,陈艳伟,何战英,等.北京市2007-2015年手足口病时间分布特征分析[J].国际病毒学杂志,2016,23(3):145-147.DOI:10.3760/cma.j.issn.1673-4092.2016.03.001.Li XT,Chen YW,He ZY,et al.Analysis on the seasonality of hand,foot and mouth disease in Beijing from 2007 to 2015[J].Int J Virol,2016,23(3):145-147.DOI:10.3760/cma.j.issn.1673-4092.2016.03.001.
[6]胡跃华,廖家强,冯国双,等.自回归移动平均模型在全国手足口病疫情预测中的应用[J].疾病监测,2014,29(10):827-832.DOI:10.3784/j.issn.1003-9961.2014.10.018.Hu YH,Liao JQ,Feng GS,et al.Application of multiple seasonal autoregressive integrated moving average model in prediction of incidence of hand,foot and mouth disease in China[J].Dis Surveill,2014,29(10):827-832.DOI:10.3784/j.issn.1003-9961.2014.10.018.
[7]刘宏灵,刘莹莹,于秋丽,等.2011-2014年河北省手足口病流行特征及病原特征分析[J].现代预防医学,2016,43(13):2315-2319.DOI:10.16462/j.cnki.zhjbkz.2017.02.011.Liu HL,Liu YY,Yu QL,et al.Epidemiology and etiology of hand,foot and mouth disease in Hebei province,2011-2014[J].Mod Prev Med,2016,43(13):2315-2319.DOI:10.16462/j.cnki.zhjbkz.2017.02.011.
[8]陈国平,史永林,张进,等.2008-2014年安徽省手足口病流行特征分析[J].现代预防医学,2016,43(4):588-590,630.Chen GP,Shi YL,Zhang J,et al.Analysis of the epidemiological characteristics of hand,foot and mouth disease in Anhui province between 2008 and 2014[J].Mod Prev Med,2016,43(4):588-590,630.
[9]Chen KT,Chang HL,Wang ST,et al.Epidemiologic features of hand,foot adn mouth disease and herpangina caused by enterovirus71 in Taiwan,1998-2005[J].Pediatrics,2007,120(2):e244-e252.DOI:10.1542/peds.2006-3331.
[10]彭瑞吟,甘露,彭清琴,等.2010-2014年深圳市宝安区手足口病流行特征研究[J].现代预防医学,2016,43(8):1377-1380.Peng RY,Gan L,Peng QQ,et al.Analysis on epidemiological characteristics of hand,foot and mouth disease in Bao′an district of Shenzhen from 2010 to 2014[J].Mod Prev Med,2016,43(8):1377-1380.
[11]国家卫生健康委员会办公厅.手足口病诊疗指南(2018年版)[EB/OL].(2018-05-15)[2018-05-20].http://www.nhc.gov.cn/yzygj/s3594q/201805/5db274d8697a41ea84e88eedd8bf8f63.shtml.National Health Commission of People′s Republic of China.Hand,foot and mouth disease diagnosis and treatment guidelines(2018edition)[EB/OL].(2018-05-15)[2018-05-20].http://www.nhc.gov.cn/yzygj/s3594q/201805/5db274d8697a41ea84e88eedd8bf8f63.shtml.
[12]王永军.新生儿手足口病一例[J].中国新生儿科杂志,2014,29(1):66.DOI:10.3969/j.issn.1673-6710.2014.01.020.Wang YJ.One neonatal case of hand,foot and mouth disease[J].Chin J Neonatol,2014,29(1):66.DOI:10.3969/j.issn.1673-6710.2014.01.020.
[13]但蓓蓓.新生儿手足口病一例[J].临床误诊误治,2016,29(6):23.Dan BB.One neonatal case of hand,foot and mouth disease[J].Clin Misdiagnios Misth,2016,29(6):23.
[14]占华剑,柯昌文.全球手足口病流行现状及分子流行病学研究进展[J].华南预防医学,2011,37(5):34-38,41.Zhan HJ,Ke CW.The global present epidemic situation and research progress of molecular epidemiology of hand,foot and mouth disease[J].South China J Prev Med,2011,37(5):34-38,41.