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[2012年至2020年成都市手足口病流行病学特征及EV71疫苗接种效果]

[Epidemiological Characteristics of Hand, Foot, and Mouth Disease and the Effect of EV71 Vaccination in Chengdu from 2012 to 2020].

作者信息

Tang Xue-Qin, Zhang Liang-Zhi, Meng Jian-Tong, Chen Heng, Cheng Yue, Yuan Ping, Long Lu

机构信息

Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China.

Department of Immunization Planning, Chengdu Municipal Center for Disease Control and Prevention, Chengdu 610041, China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2022 Nov;53(6):1074-1080. doi: 10.12182/20220860103.

Abstract

OBJECTIVE

To analyze the epidemiological characteristics of hand, foot, and mouth disease (HFMD) in Chengdu from 2012 to 2020, to make comparison in order to examine the changes in incidence before and after vaccination was introduced, and to provide basis for the prevention of HFMD in the future.

METHODS

Descriptive epidemiological methods were adopted to analyze the incidence, mortality and rate of severe cases of HFMD cases reported in Chengdu from 2012 to 2020.

RESULTS

From 2012 to 2020, the cumulative cases of HFMD reported in Chengdu were as many as 279216, of which, there were 2201 severe cases and 16 deaths. The incidence increased every other year, reaching 326.43 per 100000 person-years, the highest ever, in 2018. The rate of severe cases and mortality had shown a decreasing trend since 2016. A total of 11892 cases of EV71, CoxA16 and other enteroviruses were detected in the laboratory, accounting for 14.8%, 18.8% and 66.3%, respectively. Since 2016, HFMD cases caused by EV71 virus infection had shown an overall decreasing trend, cases caused by Cox A16 virus infection had increased every other year, and cases caused by other enteroviral infections had shown an overall increasing trend. The reported cases were mainly concentrated in children aged 0-5 years (92.1%), with those in the age group of 1-2 years reporting the highest number of cases. For children of different ages, male patients always outnumber female patients. The geographic distribution showed that the areas with high HFMD incidence were always located in the central part of Chengdu City, and the three districts with the highest incidence growth rate were Qingbaijiang District, Shuangliu District, and Longquanyi District. Temporal distribution of HFMD cases showed an obvious bimodal distribution, with most of the cases concentrated in May through August and October through December of each year. The number of new cases reached the highest (12309 cases) in July 2018.

CONCLUSION

While continuing to promote EV71 vaccination in the future, Chengdu also needs to pay more attention to viral infection serotypes other than EV71 and Cox A16 and conduct research on multivalent vaccines against a variety of enteroviruses. The focus of prevention and control can be placed on areas with high population density, large floating populations, large numbers of agriculture-related communities, and insufficient individual awareness of hygiene. For the second circle of Chengdu city, the disinfection of agriculture-related communities should be strengthened, and information sessions or other health education activities could be organized for individuals and daycare facilities with low awareness of the importance of hygiene. In addition, more attention should be given to the prevention and control of HFMD in the high incidence seasons.

摘要

目的

分析2012年至2020年成都市手足口病(HFMD)的流行病学特征,进行对比以考察引入疫苗前后发病率的变化情况,为今后手足口病的预防提供依据。

方法

采用描述性流行病学方法分析2012年至2020年成都市报告的手足口病病例的发病率、死亡率及重症率。

结果

2012年至2020年,成都市报告的手足口病累计病例多达279216例,其中重症病例2201例,死亡16例。发病率每隔一年上升,在2018年达到每10万人年326.43例,为历年最高。自2016年以来,重症率和死亡率呈下降趋势。实验室共检测出11892例肠道病毒71型(EV71)、柯萨奇病毒A16型(CoxA16)及其他肠道病毒,分别占14.8%、18.8%和66.3%。自2016年以来,EV71病毒感染所致手足口病病例总体呈下降趋势,Cox A16病毒感染所致病例每隔一年上升,其他肠道病毒感染所致病例总体呈上升趋势。报告病例主要集中在0 - 5岁儿童(92.1%),其中1 - 2岁年龄组报告病例数最多。不同年龄段儿童中,男性患者始终多于女性患者。地理分布显示,手足口病高发地区始终位于成都市中心城区,发病率增长率最高的三个区为青白江区、双流区和龙泉驿区。手足口病病例的时间分布呈明显的双峰分布,大部分病例集中在每年的5月至8月和10月至12月。2018年7月新发病例数达到最高(12309例)。

结论

未来在继续推广EV71疫苗接种的同时,成都市还需更加关注除EV71和Cox A

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