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目的分析湖南省2009—2015年手足口病重症病例流行病学特征,为科学防治手足口病提供依据。方法收集2009—2015年湖南省手足口病重症/死亡病例个案数据,采用描述性流行病学方法进行分析。结果 2009—2015年重症发病呈现隔年高发的周期性变化,2010、2012、2014年为相对高发年份,占7年重症病例总数的82.45%;地区分布以湖南省西部和南部地区高发,年龄主要集中在5岁以下儿童,占96.71%;发病-初诊间隔中位数为1 d,从发病到诊断重症时间间隔中位数为2 d,初诊到诊断重症时间间隔中位数为1 d;97.26%的病例有发热症状,96.77%的病例有皮疹,发热伴出疹的有6 184例,占94.66%;共对5 319例重症/死亡病例进行实验室检测,阳性4 213例,其中EV71阳性2 569例,占60.98%,Cox A16阳性221例,占5.25%,其他肠道病毒阳性1 423例,占33.78%。结论需要不断加强手足口病监测、风险评估和预警工作,同时加强基层医务人员对早期重症病例识别和规范药物使用等知识的培训,加大农村地区散居儿童家庭的健康宣传力度等综合防控措施,以最大限度的减少手足口病重症和死亡病例的发生。
Objective To analyze the epidemiological characteristics of HFMD in Hunan Province from 2009 to 2015 and provide the basis for scientific prevention and treatment of HFMD. Methods The data of severe case / death of HFMD in Hunan Province from 2009 to 2015 were collected and analyzed by descriptive epidemiological method. Results The incidence of severe diseases in 2009-2015 showed periodic changes with high incidence in each year, with relatively high incidence in 2010, 2012 and 2014, accounting for 82.45% of the total. The distribution was mainly in western and southern Hunan Province, The median age at first visit was 1 day. The median interval from onset to diagnosis of severe disease was 2 days. The median time to first diagnosis to diagnosis was 1 day. The median time to diagnosis was 97.26% Of the cases had fever symptoms. There were 6 184 cases (94.66%) with fever and rash in 96.77% of the cases, and 5 213 cases of severe / death cases were detected in the laboratory, of which 4 213 cases were EV71 positive 569 cases, accounting for 60.98%, Cox A16 positive 221 cases, accounting for 5.25%, other 423 cases of enterovirus positive, accounting for 33.78%. Conclusions The monitoring, risk assessment and early warning of HFMD needs to be strengthened continuously. At the same time, primary health care workers should be trained in knowledge of early severe case identification and standardization of drug use, and more comprehensive prevention and control measures should be taken to increase health promotion of diaspora families in rural areas , To minimize the incidence of HFMD and deaths.