首页|2013-2021年云南省红河州手足口病流行病学及病原学特征分析

2013-2021年云南省红河州手足口病流行病学及病原学特征分析

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目的 分析2013-2021年云南省红河州手足口病(hand,foot and mouth disease,HFMD)流行病学和病原学特征,为制定HFMD防控策略提供依据.方法 通过中国疾病预防控制信息系统收集2013-2021年云南省红河州HFMD病例资料,采用描述性流行病学分析方法,对发病率、重症率、死亡率进行分析.Real-time PCR法对16 586例HFMD病例咽拭子、肛拭子或粪便标本进行肠道病毒A组71型(enterovirus-A71,EV-A71)及柯萨奇病毒A组16型(Coxsackievirus-A16,CV-A16)核酸检测,并分析病原学特征.结果 2013-2021年云南省红河州共报告HFMD 78356例,其中重症354例,死亡11例.HFMD年均发病率为187.47/10万,2013-2015年发病率逐年上升,2015年达第1个峰值;2016-2017年发病率逐年下降;2018年发病率升高,达第2个峰值后,逐渐下降并趋于平缓.2015年后,重症率和死亡率均呈下降趋势.0~7岁为高发年龄段,占发病总数的97.85%(76 670/78 356),1~<2岁组年均发病率最高(4 397.98/10万).一般呈现2个发病高峰,分别为4~7(夏季峰)和10~12月份(秋季峰),夏季峰高于秋季峰.男性发病例数及重症例数均明显高于女性(x2分别为1 154.436和5.183,P均<0.05).红河州北部地区年均发病率及重症率均明显高于南部地区(x2分别为18 573.742和11.036,P均<0.05),16 586例HFMD病例中,EV-A71、CV-A16和其他肠道病毒占比分别为18.71%、20.38%和60.91%,差异有统计学意义(x2=5 426.965,P<0.05).2013及2015年EV-A71为优势病原,2014年CV-A16为优势病原,2016-2021年其他肠道病毒成为优势病原.结论 2013-2021年云南省红河州HFMD流行趋势呈季节性和地区性,7岁以下儿童是重点发病人群,2016年后其他肠道病毒成为优势病原.应加强HFMD防控知识宣传,倡导良好的卫生习惯,提高家长的防病意识;加强EV-A71疫苗接种,降低EV-A71感染,有效预防重症和死亡病例.
Epidemiological and etiological characteristics of hand,foot and mouth disease in Honghe Prefecture,Yunnan Province from 2013 to 2021
Objective To analyze the epidemiological and etiological characteristics of hand,foot and mouth disease(HFMD)in Honghe Prefecture,Yunnan Province from 2013 to 2021,and provide basis for the development of prevention and control strategies for HFMD.Methods The case data of HFMD in Honghe Prefecture,Yunnan Province from 2013 to 2021 were extracted from the"China Disease Prevention and Control Information System".Descriptive epidemiological analysis method was used to analyze the incidence rate,severe rate,mortality rate.The nucleic acids of enterovirus-A71(EV-A71)and Coxsackievirus-A16(CV-A16)were detected by Real-time PCR in throat swabs,anal swabs or stool samples from 16 586 cases of HFMD,and the etiological characteristics were analyzed.Results A total of 78 356 cases of HFMD were reported from 2013 to 2021 in Honghe Prefecture,Yunnan Province,with 354 severe cases and 11 deaths.The average annual incidence rate of HFMD was 187.47/100 000,with an upward trend from 2013 to 2015,and reached the first peak in 2015,which showed a downward trend from 2016 to 2017,while increased,reached the second peak,and then gradually decreased and tended to be flat in 2018.The severe and death rates have been declining since 2015.The age group of 0~7 years old showed high incidence,which accounted for 97.85%(76 670/78 356)of the total incidence,and the average annual incidence of 1~2 years old group was the highest(4 397.98/100 000).Generally,the time distribution showed a bimodal distribution,which were from April to July(summer peak)and from October to December(autumn peak),and the peak in summer was higher than that in autumn.The number of cases and severe cases in males were signifi-cantly higher than those in females(x2=1 154.436 and 5.183,respectively,each P<0.05).The average annual inci-dence and severe rate in the northern part of Honghe Prefecture were significantly higher than those in the southern part(x2=18 573.742 and 11.036,respectively,each P<0.05).Among 16 586 HFMD cases,EV-A71,CV-A16 and other enteroviruses accounted for 18.71%,20.38%and 60.91%of cases,respectively,with significant difference(x2=5 426.965,P<0.05).The dominant pathogen was EV-A71 in 2013 and 2015,while CV-A16 in 2014,and other enteroviruses became the dominant pathogens in 2016-2021.Conclusion The epidemic trend of HFMD in Honghe Prefecture,Yunnan Province from 2013 to 2021 was seasonal and regional,with children under the age of 7 being the key population,and other enteroviruses have become the dominant pathogens after 2016.HFMD prevention and control knowledge publicity should be strengthened,good hygiene habits should be advocated,and parents'awareness of disease prevention should be raised.EV-A71 vaccination should be strengthened to reduce EV-A71 infection and effectively prevent severe cases and deaths.

Hand,food and mouth disease(HFMD)Epidemiological characteristicsEtiological characteristics

倪刚、李青、倪忠梅、沈静华、牟建春、史磊、姚宇峰

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红河州疾病预防控制中心,云南蒙自 661100

昆明医科大学研究生院,云南昆明 650500

红河州第三人民医院科研管理科,云南个旧 661000

中国医学科学院北京协和医学院医学生物学研究所,云南昆明 650118

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手足口病 流行病学特征 病原学特征

云南省生物医药领域科技计划

202002AA100009

2024

中国生物制品学杂志
中华预防医学会,长春生物制品研究所有限责任公司

中国生物制品学杂志

CSTPCD
影响因子:0.417
ISSN:1004-5503
年,卷(期):2024.37(1)
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