北京市2011-2017年手足口病重症病例流行特征和危险因素
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摘要
目的了解北京市手足口病(Hand, foot and mouth disease,HFMD)重症病例流行特征和危险因素。方法通过中国疾病预防控制信息系统收集2011-2017年北京市重症HFMD病例监测数据,进行描述性分析,采用Logistic回归分析HFMD重症的危险因素。结果 2011-2017年北京共报告HFMD重症病例1 035例,占HFMD总病例数的0.45%,报告重症发病率为0.70/10万,年发病率范围为0.15/10万(2017年)-1.71/10万(2012年)。在所有重症病例中,76.52%发生在4-8月份;≤3岁病例占84.25%;男女性别比为1.75:1;近郊区的朝阳、海淀、丰台病例分别占20.48%、14.59%、12.66%。348例重症病例肠道病毒核酸检测阳性,其中肠道病毒A71型(EV-A71)、柯萨奇病毒A16型、其他肠道病毒分别占46.55%、14.94%、38.51%。Logistic回归分析显示,发病年龄在0-3岁、发病至就诊时间为2-5d、居住在近郊区、EV-A71和其他肠道病毒感染是HFMD重症的危险因素。结论北京市HFMD重症发病呈下降趋势,以婴幼儿为主,需加强婴幼儿EV-A71疫苗接种及病原学检测。
Objective To determine epidemiological characteristics of severe hand, foot and mouth disease(HFMD)cases and their risk factors in Beijing. Methods We used the Chinese Disease Control and Prevention Information System to collect severe HFMD cases during 2011-2017 in Beijing for a descriptive analysis. We used a logistic regression model to analyze risk factors of severe HFMD. Results A total of 1 035 severe HFMD cases(0.45% of all HFMD cases) were reported during 2011-2017 in Beijing, for an incidence rate of 0.70 per 100 000 population with a range from 0.15 per 100 000(2017) to 1.71 per 100 000(2012) by year. Among severe cases, 76.52% occurred in AprilAugust; 84.25% were ≤3 years old; the male to female ratio was 1.75:1; and 20.48%, 14.59%, and 12.66% were reported f rom urban-suburban areas-Chaoyang, Haidian, and Fengtai districts. Among these severe cases, 348 were PCRpositive for enterovirus, in which enterovirus A71(EV-A71), Coxsackie virus A16, and other enterovirus infections accounted for 46.55%, 14.94%, and 38.51%, respectively. Logistic regression showed that being 0-3 years of age,having a 2-5-day interval from onset to a medical visit, residing in urban-suburban areas, and being infected with EV-A71 or another enterovirus were risk factors of severe HFMD. Conclusions The incidence of severe HFMD showed a declining trend in Beijing, with the highest incidence among young children. We should enhance EV-A71 vaccination and etiology determination of HFMD among young children.
Objective To determine epidemiological characteristics of severe hand, foot and mouth disease(HFMD)cases and their risk factors in Beijing. Methods We used the Chinese Disease Control and Prevention Information System to collect severe HFMD cases during 2011-2017 in Beijing for a descriptive analysis. We used a logistic regression model to analyze risk factors of severe HFMD. Results A total of 1 035 severe HFMD cases(0.45% of all HFMD cases) were reported during 2011-2017 in Beijing, for an incidence rate of 0.70 per 100 000 population with a range from 0.15 per 100 000(2017) to 1.71 per 100 000(2012) by year. Among severe cases, 76.52% occurred in AprilAugust; 84.25% were ≤3 years old; the male to female ratio was 1.75:1; and 20.48%, 14.59%, and 12.66% were reported f rom urban-suburban areas-Chaoyang, Haidian, and Fengtai districts. Among these severe cases, 348 were PCRpositive for enterovirus, in which enterovirus A71(EV-A71), Coxsackie virus A16, and other enterovirus infections accounted for 46.55%, 14.94%, and 38.51%, respectively. Logistic regression showed that being 0-3 years of age,having a 2-5-day interval from onset to a medical visit, residing in urban-suburban areas, and being infected with EV-A71 or another enterovirus were risk factors of severe HFMD. Conclusions The incidence of severe HFMD showed a declining trend in Beijing, with the highest incidence among young children. We should enhance EV-A71 vaccination and etiology determination of HFMD among young children.
引文
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[7]郑亚明,杨娟.2013-2015年我国手足口病死亡病例社会经济负担估计[J].疾病监测,2017,32(6):516-520.ZHENG Y,YANG J.Estimation ofsocial economic burden caused by fatal hand,foot and mouth disease cases in China,2013-2015[J].Disease Surveillance,2017,32(6):516-520.
[8]张爱平,刘凤仁,李刚,等.2009-2012年深圳市龙岗区手足口病流行特征及其危险因素分析[J].实用预防医学,2013,20(7):789-791.ZHANG A,LIU F,LI G,et al.Analysis ofepidemiological features ofsevere cases ofhand foot mouth disease and its risk factors in Longgang district ofShenzhen city from 2009 to 2012[J].Practical Preventive Medicine,2013,20(7):789-791.
[9]蔡春燕,王娟,王忠敏,等.2011-2012年杭州市儿童手足口病流行病学特征及重症病例危险因素分析[J].中国预防医学杂志,2016,17(6):419-423.CAI C,WANG J,WANG Z,et al.Epidemiological analysis ofhand-foot-mouth disease and risk factors ofsevere cases in Hangzhou in 2011-2012[J].Chinese Preventive Medicine,2016,17(6):419-423.
[10]崔利强,张彦岭.2016年洛阳市手足口病重症病例流行病学特征分析[J].国际病毒学杂志,2018,25(2):118-121.CUI L,ZHANG Y.Study on epidemiological characteristics ofthe severe cases ofhand,foot,and mouth disease in Luoyang,2016[J].International Journal ofVirology,2018,25(2):118-121.
[11]李昊天,王小莉,王全意,等.手足口病重症及死亡病例基本特征概述[J].国际病毒学杂志,2018,25(2):139-142.LI H,WANG X,WANG Q,et al.Basic characteristics ofsevere and fatal cases ofhand foot and mouth disease[J].International Journal ofVirology,2018,25(2):139-142.
[12]潘静静,康锴,王彦霞,等.河南省2010年重症手足口病流行特征及影响因素分析[J].现代预防医学,2012,39(23):6101-6103+6109.PAN J,KANG K,WANG Y,et al.Analysis ofepidemiological characteristics and influencing factors ofsevere cases ofhand-foot-mouth disease in Henan province in 2010[J].Modern Preventive Medicine,2012,39(23):6101-6103+6109.
[13]郑亚明,常昭瑞,姜黎黎,等.手足口病重症病例分析:基于全国手足口病监测试点数据[J].中华流行病学杂志,2017,38(6):759-762.ZHENG Y,CHANG Z,JIANG L,et al.Severe cases with hand,foot and mouth disease:data based on national pilot hand,foot and mouth disease surveillance system[J].Chinese Journal ofEpidemiology,2017,38(6):759-762.
[14]RYU WS,KANG B,HONG J,et al.Clinical and et iological charact e r ist ics ofent e rovi rus 71-relat ed diseases during a recent 2-year period in Korea[J].J Clin Microbiol,2010,48(7):2490-2494.
[15]刘丹,苏豪浩,王建红,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.LIU D,SU H,WANG J,et al.Epidemiologic features and risk factors ofsevere hand-foot-mouth disease[J].The Journal ofPractical Medicine,2013,29(6):995-998.
[16]杜文燕,王玲芝,夏琪.手足口病重症病例危险因素分析[J].实用预防医学,2015,22(8):972-974.DU W,WANG L,XIA Q,et al.Risk factors ofsevere hand-foot-mout h disease[J].P r act ica l Pr event ive Medicine,2015,22(8):972-974.
[17]吕华坤,缪梓萍,王笑笑,等.浙江省手足口病重症危险因素分析[J].疾病监测,2009,24(9):658-660.LV H,MIAO Z,WANG X,et al.Analysis on risk factors ofsevere cases ofhand foot and mouth disease in Zhejiang province[J].Disease Surveillance,2009,24(9):658-660.
[2]KOH WM,BOGICH T,SIEGEL K,et al.The epidemiology ofhand,foot and mouth disease in Asia:a systematic review and analysis[J].The Pediatric Infectious Disease Journal,2016,35(10):e285-300.
[3]OOI MH,WONG SC,LEWTHWAITE P,et al.Clinical features,diagnosis,and management ofenterovirus 71[J].Lancet Neurology,2010,9(11):1097-1105.
[4]王小莉,霍达,贾蕾,等.北京市2011-2015年手足口病经济负担的探索性研究[J].国际病毒学杂志,2017,24(2):99-103.WANG X,HUO D,JIA L,et al.An exploratory study on the economic burden ofhand-foot-mouth disease in Bei jing,2011-2015[J].International Journal ofVirology,2017,24(2):99-103.
[5]ZHENG Y,JIT M,WU JT,et al.Economic costs and health-related quality oflife for hand,foot and mouth disease(HFMD)patients in China[J].PLoS One,2017,12(9):e0184266.
[6]郑亚明,杨娟,廖巧红.手足口病重症患者健康相关生存质量评估[J].中华流行病学杂志,2017,38(4):462-466.ZHENG Y,YANG J,LIAO Q,et al.Health related quality oflife on severe hand,foot and mouth disease patients[J].Chinese Journal ofEpidemiology,2017,38(4):462-466.
[7]郑亚明,杨娟.2013-2015年我国手足口病死亡病例社会经济负担估计[J].疾病监测,2017,32(6):516-520.ZHENG Y,YANG J.Estimation ofsocial economic burden caused by fatal hand,foot and mouth disease cases in China,2013-2015[J].Disease Surveillance,2017,32(6):516-520.
[8]张爱平,刘凤仁,李刚,等.2009-2012年深圳市龙岗区手足口病流行特征及其危险因素分析[J].实用预防医学,2013,20(7):789-791.ZHANG A,LIU F,LI G,et al.Analysis ofepidemiological features ofsevere cases ofhand foot mouth disease and its risk factors in Longgang district ofShenzhen city from 2009 to 2012[J].Practical Preventive Medicine,2013,20(7):789-791.
[9]蔡春燕,王娟,王忠敏,等.2011-2012年杭州市儿童手足口病流行病学特征及重症病例危险因素分析[J].中国预防医学杂志,2016,17(6):419-423.CAI C,WANG J,WANG Z,et al.Epidemiological analysis ofhand-foot-mouth disease and risk factors ofsevere cases in Hangzhou in 2011-2012[J].Chinese Preventive Medicine,2016,17(6):419-423.
[10]崔利强,张彦岭.2016年洛阳市手足口病重症病例流行病学特征分析[J].国际病毒学杂志,2018,25(2):118-121.CUI L,ZHANG Y.Study on epidemiological characteristics ofthe severe cases ofhand,foot,and mouth disease in Luoyang,2016[J].International Journal ofVirology,2018,25(2):118-121.
[11]李昊天,王小莉,王全意,等.手足口病重症及死亡病例基本特征概述[J].国际病毒学杂志,2018,25(2):139-142.LI H,WANG X,WANG Q,et al.Basic characteristics ofsevere and fatal cases ofhand foot and mouth disease[J].International Journal ofVirology,2018,25(2):139-142.
[12]潘静静,康锴,王彦霞,等.河南省2010年重症手足口病流行特征及影响因素分析[J].现代预防医学,2012,39(23):6101-6103+6109.PAN J,KANG K,WANG Y,et al.Analysis ofepidemiological characteristics and influencing factors ofsevere cases ofhand-foot-mouth disease in Henan province in 2010[J].Modern Preventive Medicine,2012,39(23):6101-6103+6109.
[13]郑亚明,常昭瑞,姜黎黎,等.手足口病重症病例分析:基于全国手足口病监测试点数据[J].中华流行病学杂志,2017,38(6):759-762.ZHENG Y,CHANG Z,JIANG L,et al.Severe cases with hand,foot and mouth disease:data based on national pilot hand,foot and mouth disease surveillance system[J].Chinese Journal ofEpidemiology,2017,38(6):759-762.
[14]RYU WS,KANG B,HONG J,et al.Clinical and et iological charact e r ist ics ofent e rovi rus 71-relat ed diseases during a recent 2-year period in Korea[J].J Clin Microbiol,2010,48(7):2490-2494.
[15]刘丹,苏豪浩,王建红,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.LIU D,SU H,WANG J,et al.Epidemiologic features and risk factors ofsevere hand-foot-mouth disease[J].The Journal ofPractical Medicine,2013,29(6):995-998.
[16]杜文燕,王玲芝,夏琪.手足口病重症病例危险因素分析[J].实用预防医学,2015,22(8):972-974.DU W,WANG L,XIA Q,et al.Risk factors ofsevere hand-foot-mout h disease[J].P r act ica l Pr event ive Medicine,2015,22(8):972-974.
[17]吕华坤,缪梓萍,王笑笑,等.浙江省手足口病重症危险因素分析[J].疾病监测,2009,24(9):658-660.LV H,MIAO Z,WANG X,et al.Analysis on risk factors ofsevere cases ofhand foot and mouth disease in Zhejiang province[J].Disease Surveillance,2009,24(9):658-660.