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目的分析杨浦区2009至2013年手足口病的流行病学和病原学特征,为手足口病的防治提供科学依据。方法利用国家疾病监测信息管理系统开展手足口病监测,采用描述性流行病学方法对杨浦区2009至2013年手足口病监测资料和部分患者病原学监测结果进行统计和分析,采用实时荧光PCR方法对部分手足口病例进行肠道病毒(enterovirus,EV)核酸检测。结果 2009至2013年,杨浦区累计报告手足口病病例4 974例,年均发病率为75.53/10万,累计报告重症病例9例,占报告病例的0.18%,无死亡病例;发病的高峰期集中在4~7月,流行高峰呈逐年升高的趋势,且高峰有延迟现象;各街道的发病率随着时间的推移呈逐年上升的趋势(Ptrend<0.05),各街道每年发病率有所不同(P<0.05);人群的发病特征以5岁及以下的散居和幼托儿童为主;2010年主要以EV71和Cox A16为流行株,2011至2013年主要以其他肠道病毒和Cox A16为流行株,其他肠道病毒所占比例有所增加,流行高峰前和流行高峰后病原谱曲线呈交叉现象。结论杨浦区手足口病有明显的季节性、地区性和人群特征,不同年份间流行优势株有所差别,优势病原株的转化影响疫情流行趋势和严重程度。
Objective To analyze the epidemiological and etiological characteristics of HFMD from 2009 to 2013 in Yangpu District and to provide a scientific basis for the prevention and treatment of HFMD. Methods To monitor hand-foot-mouth disease with National Disease Surveillance Information Management System, descriptive epidemiological method was used to analyze the monitoring data of hand-foot-mouth disease and some patients’ pathogeny monitoring results from 2009 to 2013 in Yangpu District. Real-time fluorescence PCR Some cases of hand, foot and mouth cases of enterovirus (EV) nucleic acid detection. Results A total of 4 974 hand-foot-mouth disease cases were reported in Yangpu district from 2009 to 2013, with an average annual incidence of 75.53 / 100 000. Nine cumulative cases of severe cases were reported, accounting for 0.18% of the reported cases, with no deaths. The peak incidence Concentration in April to July, the epidemic peak showed a year-by-year upward trend, and the peak delay; the incidence of the street showed a trend of increasing year by year (Ptrend <0.05), the annual incidence of each street have (P <0.05). The prevalence of the population was mainly diatomized and preschool children aged 5 years and younger. In 2010, the epidemic strains were mainly EV71 and Cox A16. From 2011 to 2013, they mainly included other enteroviruses and Cox A16 As the epidemic strain, the proportion of other enteroviruses increased, and the curve of pathogenic bacteria showed a crossover phenomenon before the epidemic peak and after the peak epidemic peak. Conclusion Hand, foot and mouth disease in Yangpu District has obvious seasonal, regional and population characteristics. The predominant strains prevail in different years. The transformation of predominant pathogenic strains affects the epidemic trend and severity.