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[目的]分析2009年聊城市手足口病流行病学特征,研究聊城市手足口病重症患儿发病高危因素,为控制手足口病、最大限度降低重症发生率提供科学依据。[方法]收集整理聊城市2009年各级各类医疗机构报告的手足口病报告卡信息及2009年RT-PCR实验室检测结果,对50例重症患者开展流行病学调查。[结果]2009年聊城市手足口病报告发病率277.60/10万,重症641例,重症发生率4%,死亡3例,病死率为0.02%。全市8个县区均有手足口病病例报告。县区之间报告发病率差异有统计学意义(P<0.01)。4~9月为报告发病高峰。病例年龄分布以小年龄组为主,5岁以下儿童报告发病15 504例,占总病例数的96.8%,1岁组患儿重症发生率最高,占总重症数的47.27%。共检测65份样本,EV71阳性率为12.3%、CoxA16 5.9%;在基层接受治疗、多次转诊是重症发生的重要原因。[结论]聊城市手足口病防控形势严峻,对5岁以下年龄组人群应加强手足口病监测工作。对重症发生率高的地区临床医护人员进行救治能力的强化培训及严格落实禁止基层医疗机构接诊发热皮疹患者的相关规定,实施以开展爱国卫生运动、强化健康教育宣传、落实群防群控等为主的综合防控措施经证明是富有成效的。但这种“严防死守”的防治措施在短期内虽效果显著,但很难坚持,应建立一种传染病防控宣传教育及临床救治的长效机制,防患于未然。
[Objective] To analyze the epidemiological characteristics of hand-foot-mouth disease in Liaocheng in 2009 and study the risk factors of hand-foot-mouth disease in Liaocheng city in order to provide a scientific basis for controlling hand-foot-mouth disease and minimizing the incidence of severe diseases. [Methods] The information of hand-foot-mouth disease report card reported by various medical institutions in Liaocheng city in 2009 and the results of RT-PCR laboratory in 2009 were collected and analyzed. Epidemiological investigation was carried out in 50 cases of severe patients. [Results] The incidence of hand-foot-mouth disease in Liaocheng in 2009 was 277.60 / 100 000, of which 641 were severe, 4% were severe, 3 died, and the case fatality rate was 0.02%. The city’s eight counties have cases of hand, foot and mouth disease report. There was a significant difference in the reported incidence between counties (P <0.01). April to September peak incidence of the report. The age distribution of cases was mainly in the younger age group, and 15 504 cases were reported in children younger than 5 years old, accounting for 96.8% of the total cases. The incidence of severe diseases in 1-year-old children was the highest, accounting for 47.27% of the total. A total of 65 samples were tested, the positive rate of EV71 was 12.3% and that of CoxA16 was 5.9%. The treatment of primary and multiple referrals was the important cause of severe disease. [Conclusion] The situation of hand-foot-mouth disease prevention and control in Liaocheng City is very serious. Monitoring of hand-foot-mouth disease should be strengthened for people under 5 years of age. Intensified training for clinicians and nurses in areas with a high incidence of severe diseases and strictly implemented the relevant provisions prohibiting patients with fever rash from receiving visits by grass-roots medical institutions, implemented patriotic health campaigns, strengthened health education and publicity, implemented group prevention and control, etc. The comprehensive prevention and control measures proved to be fruitful. However, this kind of prevention and control measures of “preventing sticking to their own hands” will have a significant effect in the short term, but it is hard to persist. A long-term mechanism should be established to prevent and control epidemic prevention and control publicity and education and clinical treatment.