2008-2012年无锡市手足口病疫情特征及病原学分析

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目的了解无锡市2008-2012年手足口病流行趋势及其病原学变化特点,为本地区防控手足口病提供科学依据。方法通过《中国疾病预防控制信息系统》收集病例相关信息,采用描述性流行病学方法进行分析比较,收集无锡市哨点医院的手足口病例样本,进行病毒核酸检测。结果无锡市2008-2012年共报告手足口病46 534例,年均发病率161.39/10万;重症比例为22.01‰;死亡率0.014/10万。发病有两个高峰,主要集中在5-7月和11-12月,重症发生亦集中在7月;全区各县区均有发病,无锡新区、滨湖、锡山和惠山等城乡结合地区发病率较高,且重症发生率较高;普通病例男女性别比为1.48∶1,5岁以下儿童发病占93.20%,重症病例主要以散居儿童中3岁及以下儿童高发。病原学监测结果显示以EV71(占50.09%)和Cox A16(31.48%)为主,重症病例EV71阳性率明显高于普通病例。结论手足口病的发生存在明显季节性及地区、性别、年龄差异,且疫情处于上升状态,应加强对手足口病的健康教育及对农村偏远地区和城镇托幼机构的疫情监测力度,同时提高医疗机构对手足口病重症病例的诊断及救治能力。 Objective To understand the epidemiological trend of hand-foot-and-mouth disease in Wuxi from 2008 to 2012 and its etiological characteristics to provide a scientific basis for prevention and control of hand-foot-mouth disease in this area. Methods Through the collection of case-related information through “China Disease Prevention and Control Information System”, descriptive epidemiological methods were used to analyze and compare the samples collected from sentinel hospitals in Wuxi City for virus nucleic acid detection. Results A total of 46 534 hand-foot-mouth disease cases were reported in Wuxi from 2008 to 2012, with an average annual incidence of 161.39 / 100 000; the proportion of severe cases was 22.01 ‰ and the death rate was 0.014 / 100 000. There were two peak incidence, mainly in May-July and November-December, severe disease also concentrated in July; all counties in the region have onset, Wuxi New District, Binhu, Xishan and Huishan and other urban-rural areas The incidence rate is high, and the incidence of severe diseases is high. The average male / female ratio is 1.48:1. The incidence of children under the age of 5 and 5 accounts for 93.20%. The severe cases are mainly children aged 3 and under. The results of etiological surveillance showed that EV71 (50.09%) and Cox A16 (31.48%) were the major pathogens. The positive rate of EV71 in severe cases was significantly higher than that in common cases. Conclusions The occurrence of hand, foot and mouth disease is obviously seasonal, sex, age difference, and the epidemic is on the rise. Health education of hand foot and mouth disease should be strengthened and epidemic situation monitoring should be strengthened in remote rural areas and town nurseries. Diagnosis and treatment of severe cases of foot-mouth disease in medical institutions.
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