黄恩妙, 姚梓烽, 师舞阳. 2013-2017年广东省中山市手足口病重症病例流行病学和病原学特征分析[J]. 疾病监测, 2019, 34(6): 541-545. DOI: 10.3784/j.issn.1003-9961.2019.06.015
引用本文: 黄恩妙, 姚梓烽, 师舞阳. 2013-2017年广东省中山市手足口病重症病例流行病学和病原学特征分析[J]. 疾病监测, 2019, 34(6): 541-545. DOI: 10.3784/j.issn.1003-9961.2019.06.015
Enmiao Huang, Zifeng Yao, Wuyang Shi. Epidemiological and etiological characteristics of severe cases of hand foot and mouth disease in Zhongshan, Guangdong, 2013−2017[J]. Disease Surveillance, 2019, 34(6): 541-545. DOI: 10.3784/j.issn.1003-9961.2019.06.015
Citation: Enmiao Huang, Zifeng Yao, Wuyang Shi. Epidemiological and etiological characteristics of severe cases of hand foot and mouth disease in Zhongshan, Guangdong, 2013−2017[J]. Disease Surveillance, 2019, 34(6): 541-545. DOI: 10.3784/j.issn.1003-9961.2019.06.015

2013-2017年广东省中山市手足口病重症病例流行病学和病原学特征分析

Epidemiological and etiological characteristics of severe cases of hand foot and mouth disease in Zhongshan, Guangdong, 2013−2017

  • 摘要:
    目的了解广东省中山市手足口病重症病例流行病学和病原学特征,为防控工作提供依据。
    方法对2013 — 2017年中山市报告的手足口病重症病例开展个案调查和实验室检测,采用Excel 2007和SPSS 13.0软件进行数据整理和描述性分析,率的比较用χ2检验。
    结果2013 — 2017年共报告手足口病重症病例209例,占手足口病病例的0.25%(209/84 021),年均发病率为1.31/10万,每年3 — 7月为发病高峰。 病例主要为1~3岁的散居儿童,占73.68%(154/209);男性发病高于女性(χ2=15.171,P=0.000);以农村的常住人口为主。 209例重症病例均有出疹,95.22%的病例有发热,皮疹类型以疱疹为主(71.29%)。 病例发病到初诊时间间隔<3 d的占91.87%(192/209);初次就诊时能被正确诊断为手足口病的占63.64%(133/209);不同级别的医院手足口病诊断正确率差异具有统计学意义(χ2=23.831,P=0.000)。 203例手足口病重症病例采集了标本送检,阳性率为93.10%(189/203)。 病原体以肠道病毒71型(EV71)为主(118例,占58.13%),4 — 5月为检出高峰。
    结论中山市重症手足口病有明显的时间、人群和地区分布特征, EV71是主要病原体。 应针对其特征落实综合性的防控措施,并提高EV71灭活疫苗的接种率,以降低手足口病重症的发生率。

     

    Abstract:
    ObjectiveTo understand the epidemiology and etiological characteristics of severe cases of hand foot and mouth disease (HFMD) in Zhongshan of Guangdong province and provides evidence for the prevention and control of HFMD.
    MethodsCase investigation and laboratory test were conducted for the severe cases of HFMD reported in Zhongshan from 2013 to 2017. Data analysis was done by using Excel 2007 and SPSS 13.0 softwares.
    ResultsA total of 209 severe cases of HFMD were reported in Zhongshan, accounting for 0.25%(209/84 021) of total HFMD cases, with an annual average incidence of 1.31/100 000. The incidence peak was during March-July. The cases were mainly in 1–3 years old children outside child care settings, accounting for 73.68%(154/209). The incidence in boys was higher than that in girls. All the 209 severe HFMD cases had skin rash, 95.22% of the cases had fever, and the main type of rash was herpes (71.29%). The time interval between onset and initial diagnosis was less than 3 days, accounting for 91.87% (192/209). Up to 63.64% of the cases (133/209) were correctly diagnosed with HFMD at the first visit. The differences in diagnostic accuracy of HFMD among hospitals at different levels were significant. The specimens of 203 severe HFMD cases were detected, the positive rate was 93.10% (189/203). The major pathogen was EV71 (58.13%), the detection peak time was during April-May.
    ConclusionThe incidence of severe HFMD had obvious time, population and area specific characteristics in Zhongshan. The major pathogen was EV71. It is necessary to take comprehensive measures and increase the vaccination coverage of EV71 inactivated vaccine to reduce the incidence of severe cases of HFMD.

     

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