Epidemiologic characteristics and pathogen surveillance of hand, foot and mouth disease in Hebei province from 2008 to 2017
-
摘要:
目的 分析2008-2017年河北省手足口病(hand-foot-mouth disease,HFMD)的流行病学及病原特征,为HFMD的防控提供科学依据。 方法 收集2008-2017年HFMD疫情资料和实验室检测结果,进行描述流行病学分析。 结果 2008-2017年河北省累计报告HFMD病例690 368例,重症4 939例,死亡208例,年均发病率为95.53/10万。2009年,轻型病例报告病例数最多,而重症和死亡则是2010年。报告发病人数呈隔年增加但总体减少的趋势。2008年、2009年和2012年4~6月份间形成春夏季发病主高峰,2010年、2011年和2013-2017年5~7月份出现春夏主高峰,主峰值落在的月份呈向后延迟趋势。男女的性别比是1.59:1,死亡病例以散居儿童和幼托儿童为主。其它肠道病毒、肠道病毒71型(human enterovirus 71,EV-A71)和柯萨奇病毒A组16型(coxasckievirus A16,CV-A16)交替成为普通病例的主要病原,不同病例类型的病原构成不同且差异有统计学意义(χ2=2 274.17,P<0.001)。 结论 报告死亡和重症病例数呈大幅减少趋势,应适时调整防控重点,提高对HFMD轻型病例的重视,进一步加强对其他肠道病原谱的监测。 Abstract:Objective To analyze the epidemiological and pathogenic characteristics of hand-foot-mouth disease (HFMD) in Hebei Province from 2008 to 2017, so as to provide scientific evidence for prevention and control of HFMD. Methods The epidemic data and laboratory detection data of HFMD from 2008 to 2017 were collected and analyzed by descriptive epidemiology. Results From 2008 to 2017, a total of 690 368 cases of hand, foot and mouth disease, including 4 939 severe cases and 208 deaths were reported in Hebei Province, with an average annual incidence of 95.53/100 000. The largest number of reported light cases were 2009, while severe cases and deaths were in 2010. The number of reported cases increased every other year but decreased in general. In 2008, 2009 and 2012, the main peak of the onset of spring and summer was formed from April to June. In 2010, 2011 and 2013-2017, the main peak of the onset of spring and summer was from May to July. Main peak value in spring and summer showed a backward delayed trend. The sex ratio between men and women was 1.59:1.The majority of deaths case were scattered children and preschool case. Other enteroviruses, human enterovirus 71, (EV-A71) and coxasckievirus A16, (CV-A16) alternately became the main pathogens of common cases. The pathogenic composition of different cases was different and the difference was statistically significant (χ2=2274.17, P<0.001). Conclusion The number of reported deaths and severe cases has decreased significantly. It is necessary to adjust the focus of prevention and control, pay more attention to the mild cases of FHMD, and further strengthen the monitoring of other enteroviruses pathogenic spectrum. -
表 1 2008-2017年河北省HFMD发病、重症及死亡情况
Table 1. HFMD cases severe cases and death cases in Hebei, 2008-2017
年份 病例数(人) 发病率(1/10万) 重症病例数(人) 重症率(1/100) 死亡病例数(人) 死亡率(1/10万) 病死率(1/100) 2008 29 563 42.58 135 0.46 14 0.02 0.05 2009 110 148 157.61 931 0.85 28 0.04 0.03 2010 95 830 136.23 1 732 1.81 84 0.12 0.09 2011 71 864 100.03 550 0.77 19 0.03 0.03 2012 82 690 114.23 756 0.91 15 0.02 0.02 2013 56 737 77.98 215 0.38 24 0.03 0.04 2014 85 271 116.30 332 0.39 15 0.02 0.02 2015 52 422 71.00 58 0.11 0 0.00 0.00 2016 60 753 81.84 160 0.26 5 0.01 0.01 2017 45 090 60.40 70 0.16 4 0.01 0.01 合计 690 368 95.53 4 939 0.72 208 0.03 0.03 -
[1] 万朝敏, 徐爱丽. 手足口病的研究进展[J]. 中华妇幼临床医学杂志(电子版), 2009, 5(2): 106-108. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201303067.htmWan ZM, Xu AL. Research progress of hand, foot and mouth disease[J]. Chin J Obs/Gyne & Pediatr (Electronic Edition), 2009, 5(2): 106-108. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201303067.htm [2] Mirand A, Henquell C, Archimbaud C, et al. Oubreak of hand, foot and mouth disease/herpangina associated with coxsackievius A6 and A10 infections in 2010, France: a large citywide, prospective observational study[J]. Clin Microbiol Infect, 2012, 18(5): 110-118. DOI: 10.1111/j.1469-0691.2012.03789.x. [3] Davia JL, Bel PH, Ninet VZ, et al. Onychomadesis outbreak in Valencia, Spain associated with hand, foot, and mouth disease caused by enteroviruses[J]. Pediatr Dermatol, 2011, 28(1): 1-5. DOI:10.1111/j.1525- 1470.2010.011161.x. [4] Fujimoto T, Iizuka S, Enooto M, et al. Hand, foot and mouth disease caused by coxsackievirus A6, Japan, 2011[J]. Emerg infect Dis, 2012, 18(2): 337-339. DOI: 10.320/eid1802.110547. [5] 张永强, 高燕琳, 韦再华, 等. 2007-2015年北京市手足口病的流行病学特征分析[J]. 现代预防医学, 2017, 44(15): 2689-2691, 2699. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201715001.htmZhang YQ, Gao YL, Wei ZH, et al. Epideiological analysis of hand, foot and mouth disease in Beijing, 2007-2015[J]. Modern Preventive Medicine, 2017, 44(15): 2689-2691, 2699. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201715001.htm [6] 王丹, 李法锦, 姚光海, 等. 贵州省2009-2016年手足口病流行病学特征研究[J]. 中国疫苗和免疫, 2017, 23(4): 450-454. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM201704021.htmWang D, Li FJ, Yao GH, et al. Epidemiological characteristics of hand, foot and muoth disease in Guizhou, 2009-2016[J]. Chinese Journal of Vaccines and Immunization, 2017, 23(4): 450-454. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM201704021.htm [7] 何为涛, 蒋丽娜, 王东燕, 等. 广西2008-2015年手足口病流行病学特征及病原学监测分析[J]. 中国病毒病杂志, 2017, 7(2): 113-119. https://www.cnki.com.cn/Article/CJFDTOTAL-ZRYX201702008.htmHe WT, Jiang LN, Wang DY, et al. Epidemiology and pathogen surveillance of hand foot and mouth disease from 2008 to 2015 in Gangxi, China[J]. Chin J Viral Dis, 2017, 7(2): 113-119. https://www.cnki.com.cn/Article/CJFDTOTAL-ZRYX201702008.htm [8] 黄飚, 栾博, 史玉婷, 等. 吉林省2008-2014年手足口病流行病学特征分析[J]. 中国公共卫生, 2017, 33(2): 291-294. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201702029.htmHuang B, Luan B, Shi YT, et al. Epidmic characteristics of hand foot and mouth disease in Jilin province, 2008-2014[J]. Chin J Public Health, 2017, 32(2): 291-294. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201702029.htm [9] 冀天娇, 谭小华, 刘冷, 等. 广东省2008-2015年手足口病流行病学特征及病原学监测分析[J]. 病毒学报, 2016, 32(6): 713-720. https://www.cnki.com.cn/Article/CJFDTOTAL-BDXB201606007.htmJi TJ, Tan XH, Liu L, et al. Epidemiology Characteristics and Pathogen Surveillance of Hand Foot and Mouth Disease in Guangdong Province, China, 2008-2015[J]. Chinese Journal of Virology, 2016, 32(6): 713-720. https://www.cnki.com.cn/Article/CJFDTOTAL-BDXB201606007.htm [10] 刘雅琼, 袁伟, 吕强. 2009-2016年四川省手足口病流行病学和病原学特征分析[J]. 中华疾病控制杂志. 2017, 21(10): 1052-1056. DOI: 10.16462/j.cnki.zhjbkz.2017.10.020.Liu YQ, Yuan W, Lv Q. Epidemiological and etiological characteristics of hand, foot and mouth disease in Sichuan Province, 2009-2016[J]. Chin J Dis Control Prev. 2017, 21(10): 1052-1056. DOI: 10.16462/j.cnki.zhjbkz.2017.10.020. [11] Zhuang ZC, Kou ZQ, Bai YJ, et al. Epidemiological research on hand, foot, and mouth disease in mainland China[J]. Viruses, 2015, 7(12): 6400-6411. DOI: 10.1016/S1473-3099(13)70342-6.