Epidemiology and etiology of hand-foot-mouth disease in Hebei Province, 2011-2015
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摘要: 目的 分析河北省手足口病(hand foot and mouth disease,HFMD)的流行特征及病原学构成,为手足口病的防控提供科学依据。方法 利用描述流行病学方法对河北省2011-2015年疾病监测信息报告系统上报的手足口病病例和实验室检测结果进行统计分析。结果 2011-2015年累计报告手足口病病例349 113例,年均发病率为95.91/10万,其中2012年和2014年报告发病率最高,呈现隔年高水平流行的现象。高发期集中在5~7月,10~12月间又出现一个次高峰或“拖尾”峰,患者主要为≤5岁儿童,尤其以1~3岁组婴幼儿为主。各地区发病水平存在差异,以发病率和重症率为分类指标对各地市进行聚类分析和赋值评价,得到重点防控地区为廊坊市、沧州市、衡水市、石家庄市、保定市和承德市。不同年份病原构成亦不同,在2013年和2015年其他肠道病毒分别取代柯萨奇病毒A组16型(coxsachievirus A16,CoxA16)、肠道病毒71型(enterovirus 71,EV71)成为当年主要病原体,构成比高达44.89%和66.23%。结论 河北省手足口病呈现明显的季节、人群以及一定的地区分布规律,应进一步关注手足口病病原谱的变化,加强重点地区防控。Abstract: Objective To understand the epidemiological characteristics and pathogen patterns of hand-foot-mouth disease (HFMD) in Hebei Province during 2011-2015 and provide scientific evidence for the development of HFMD prevention and control measures. Methods The cases reported from the National Disease Surveillance Information Management System and laboratory testing results in Hebei Province from 2011-2015 were analyzed with the descriptive epidemiology. Results A total of 349 113 HFMD cases were reported from 2011 to 2015, with anannual incidence of 95.91/100 000. The incidence rate in 2012 and 2014 was significantly higher than in other years, presenting an epidemic phenomena of peaking every other year.There was an obvious temporal distribution of the cases, the main peak occurred in 5-7 months and the second peak or "tail" peak was in 10-12 months. The major cases afflicted with HFMD were children less than five years old, and especially those aged 1-3 years old.The epidemic in different regions was different, so the method of cluster analysis and assigned evaluation were conducted according to the incidence and severe rates, which were used as the classification index. The results showed that Langfang, Cangzhou, Hengshui, Shijiazhuang, Baoding and Chengde were the focus for prevention and control. The pathogen composition was slightly different during the five years. In 2013 and 2015, having superseding coxsachievirus A16(CoxA16) and enterovirus 71(EV71), other enteroviruses became the predominantly prevailing pathogens,accounting for 44.89% and 66.23%, respectively. Conclusions It showed a certain characteristics in seasonal, populational and regional distribution of HFMD in Hebei Province. We should pay more attention to the changes of pathogens and the key areas of prevention and control of HFMD should be enhanced.
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Key words:
- Hand, foot and mouth disease /
- Cluster analysis /
- Epidemiologic studies
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