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目的分析宁波市手足口病流行特征,为科学防控提供依据。方法利用中国疾病预防控制信息系统中2011-2015年宁波市手足口病监测资料进行描述性流行病学分析,采用实时荧光定量PCR法(realtime polymerase chain reaction,real-time PCR)对病原学监测采集的手足口病患者粪便或肛拭子标本进行肠道病毒分型。结果宁波市2011-2015年累计报告手足口病123 598例,重症病例233例,死亡9例,年均发病率323.60/10万。2011-2015年,年发病率分别为174.26/10万、338.04/10万、536.46/10万、561.62/10万和305.11/10万,发病水平呈现先明显上升后有所下降的趋势。宁海县、江北区和鄞州区发病率最高,分别为511.95/10万、440.09/10万和421.50/10万。发病高峰集中在4-7月份,男性发病率高于女性,以5岁以下儿童为主,占全部病例的94.17%,其中1~3岁年龄组发病率最高。实验室共检测标本4357份,EV-A71、CV-A16和其他肠道病毒核酸阳性率分别为36.62%、25.33%和38.05%。重症病例和死亡病例的EV-A71核酸阳性率分别为69.59%和88.89%。结论 2011-2015年宁波市手足口病的流行具有明显季节性和区域性,3岁以下儿童是手足口病防控的重点人群。宁波市手足口病的流行主要由EV-A71病毒和其他肠道病毒引起,手足口病优势病原的转化可影响疫情流行趋势和严重程度。
Objective To analyze the epidemiological characteristics of hand, foot and mouth disease in Ningbo and provide the basis for scientific prevention and control. Methods A descriptive epidemiological analysis of hand, foot and mouth disease in Ningbo City from 2011 to 2015 in the China Disease Prevention and Control Information System was carried out. The etiological surveillance data were collected by real-time PCR (real-time PCR) Of hand, foot and mouth disease in patients with fecal or anal swab samples for enterovirus typing. Results In 2011-2015, 123 598 cases of hand-foot-mouth disease were reported in Ningbo city, including 233 cases of severe disease and 9 cases of death, the annual average incidence was 323.60 / 100 000. The annual incidence rates in 2011-2015 were 174.26 / 100000, 338.04 / 100000, 536.46 / 100000, 561.62 / 100000 and 305.11 / 100000, respectively. The incidence of the disease showed a trend of declining after the first significant increase. Ninghai County, Jiangbei District and Yinzhou District had the highest incidence rates of 511.95 / 100,000, 440.09 / 100,000 and 421.50 / 100,000 respectively. The incidence peak concentrated in 4-7 months, the incidence of male higher than women, mainly children under 5 years old, accounting for 94.17% of all cases, of which 1 to 3 years old group the highest incidence. A total of 4357 samples were tested in the laboratory. The positive rates of EV-A71, CV-A16 and other enterovirus nucleic acids were 36.62%, 25.33% and 38.05% respectively. The EV-A71 positive rates of severe cases and death cases were 69.59% and 88.89% respectively. Conclusion The prevalence of hand, foot and mouth disease in Ningbo City during 2011-2015 is obviously seasonal and regional. The children under 3 years of age are the key population for prevention and control of HFMD. The prevalence of HFMD in Ningbo City is mainly caused by EV-A71 virus and other enteroviruses. The transformation of predominant pathogen of hand-foot-mouth disease can influence the epidemic trend and severity.