2009-2014年四川省泸州市手足口病流行特征及病原学监测

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目的分析四川省泸州市手足口病流行特征,为制定防控措施提供依据。方法采用描述流行病学方法对泸州市2009-2014年手足口病资料进行分析。结果 6年累计报告手足口病4 036例,其中重症14例、死亡7例,年均报告发病率为15.77/10万,居全市丙类传染病第3位,病死率为0.17%,发病率以及在丙类中的位次呈上升趋势。全年各月均有病例报告,5~6月、10~11月为流行高峰,呈双峰流行;城区发病率高于农村、重症发生率低于农村(P<0.05);男女比为1.73∶1,5岁以下儿童发病为主(93.29%),幼托儿童占有较大比例(25.40%),聚集和暴发疫情呈上升趋势,主要发生在幼儿园。近5年实验室确诊906例,肠道病毒71型(EV71)、柯萨奇病毒A16型(Cox A16)、其他肠道病毒各占25.94%、38.52%和35.54%;重症病例、散发病例与聚集病例的病原分布差异有统计学意义,EV71是造成重症和死亡的主要毒株。结论四川省泸州市手足口病呈上升趋势,多种肠道病毒交替流行或共同流行。5岁以下儿童为重点防控人群,托幼机构是重点防控场所。感染EV71者容易发展成重症并导致死亡,提高重症病例的早发现和医疗救治能力可有效降低病死率。 Objective To analyze the epidemiological characteristics of hand-foot-mouth disease in Luzhou City, Sichuan Province, and to provide basis for making prevention and control measures. Methods Descriptive epidemiological methods were used to analyze the data of HFMD in Luzhou in 2009-2014. Results A total of 4 036 HFMD cases were reported in 6 years, of which 14 were severe and 7 were fatal, with an average annual incidence rate of 15.77 / 100 000, ranking the 3rd in the city with a case fatality rate of 0.17%. The incidence rate As well as the upward trend in the ranking in category C. There were case reports in all months of the year. From May to June and from October to November, they were epidemic peaks. The prevalence rate in urban areas was higher than that in rural areas, and the incidence of severe diseases was lower than that in rural areas (P <0.05). The male-female ratio was 1.73 (1) The incidence of children under the age of 5 was mainly 93.29%. The children of kindergartens accounted for a large proportion (25.40%). The outbreak of the outbreak of aggregation and outbreak was on the rise, mainly in kindergartens. In the past five years, 906 cases were confirmed by laboratory tests, including EV71, Cox A16 and other intestinal viruses accounting for 25.94%, 38.52% and 35.54% respectively. Severe cases, sporadic cases and The distribution of pathogenicity in aggregated cases was statistically significant. EV71 was the major strain causing severe illness and death. Conclusion Hand-foot-mouth disease in Luzhou City of Sichuan Province is on the rise, and many kinds of enterovirus are alternately or co-popularized. Children under 5 years of age as the focus of prevention and control of the crowd, child care agencies are the focus of prevention and control of places. EV71 infection easily lead to severe and cause death, improve the early detection of severe cases and medical treatment can effectively reduce mortality.
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