2012—2016年南宁市重症手足口病流行病学分析

目的 探讨2012-2016年南宁市重症手足口病的临床流行病学特征及病原分布与变迁,为重症手足口病预防和控制提供依据。 方法 收集2012-2016年在广西壮族自治区妇幼保健院儿科住院的重症手足口病患儿临床资料,回顾性分析不同发病年份、年龄、性别和地区重症手足口病临床流行病学特征,采用RT-PCT法进行EV71、CoxA16和其他肠道病毒检测。 结果 2012-2016年广西壮族自治区妇幼保健院儿科共报道手足口病52 861例,其中重症病例870例,重症发病率为1.65%,重症手足口病每年有4~7月份和8~10月份2个流行高峰。发病最多的患儿为1~2岁组,占总病例数的45.40%,其次为2~3岁组,占21.15%,5岁以下患儿占97.59%,男女性别比例为2.25:1;发病人群中散居儿童占88.15%,幼托儿童占10.47%,西乡塘区和江南区发病最多分别占21.98%和16.23%。870例病例中检出肠道病毒(EV71型、CoxA16型及其他肠道病)704例,检出率为80.92%。EV71型、CoxA16型和其他肠道病毒构成比分别为40.34%、6.39%和53.27%。14例死亡病例中,EV71型检出率为85.71%,其他肠道病检出率为7.14%。2012年和2014年以EV71型流行为主,其他年份以其他肠道病毒为主。 结论 重症手足口病有明显的季节性,5岁以下儿童为易感人群,高危人群为散居、幼托儿童,女性发病率低于男性。肠道病毒是导致重症手足口病的主要病原体,EV71型感染与重症病例死亡相关,EV71型与其他肠道病毒每隔1或2年交替流行。 

Epidemiological analysis of severe hand-foot-mouth disease in Nanning from 2012 to 2016

Objective To study the clinical and epidemiological features of severe hand-foot-mouth disease (HFMD) cases from maternal and child health care hospital of Guangxi Zhuang Autonomous Region from 2012 to 2016, distribution of etiology and their changes in order to control and prevent the disease. Methods The clinical data were collected from HFMD cases in department of pediatrics in our institution from 2012 to 2016. Epidemiological characteristics of severe HFMD, including years, ages, genders and regions were retrospectively analyzed. EV71, CoxA16 and enterovirus were detected via RT-PCT. Results A total of 52 861 cases were reported during 2012 to 2016, among which 870 (1.65%) cases were severe cases. The results showed that two seasonal peaks appeared between April to July and August to October. The proportion of 1 to 2-year-old children was the largest, accounting for 45.40% of all cases, and it was 21.15% in children aged 2 to 3 years old. Children aged under 5 constituted 97.59% of all cases. There was a male predominance of severe HFMD cases, with a male-to-female ratio of 2.25:1. The majority (88.15%) of cases occurred in those children who stayed at home. The percentage of children in kindergartens was 10.47%. The proportion of cases from Xixiangtang and Jiangnan region was 21.98% and 16.46% respectively. Among the 870 samples, 704 (80.92%) were tested positive for EV, including EV71(40.34%), Cox A16(6.39%) and other EV (53.27%)type. Out of 14 fatal cases, EV71 was identified in 85.71% of all death cases. Other EV was identified in 7.14% of all death cases. The prevalent strain was EV71 in 2012 and in 2014, and it was other EV in other years. Conclusion There was a seasonal fluctuation about the epidemic severe HFMD. Severe HFMD was more likely to occur in children under five years old. High-risk populations were scattered children and children in childcare, and boys were more easily affected than girls. EV was the major pathogen causing severe HFMD, and EV71 was the predominant pathogen leading cause of severe and death cases. EV71 showed popular superiority strains every one or two years.