武汉阳逻地区2008至2012年手足口病流行特征分析

摘要

Objective To explore the epidemic and virological characteristics of hand-foot-mouth disease among children during 2008 to 2012 in Yangluo of Wuhan City, so as to provide scientific basis for prevention and control of the disease.Methods The clinical data of 874 cases of hand-foot-mouth disease treated in pediatric department of Yangluo School District of Hubei Zhongshan Hospital were collected during the period of 2008 to 2012, and they were analyzed with descriptive epidemiological methods.Results Among 874 cases, there were 584 male cases and 290 female cases.The number of cases showed a rising trend during 2008 to 2011 (χ2 =36.54,P<0.001), but it declined in 2012.The peak onset time was April to September, and onset age gave priority to under five years old.The crowd gave priority to scattered children or preschool children.The incidence of severe disease was significantly higher in 2011 (χ2 =16.92,P<0.001) .The incidence of the disease was higher in boys than girls, and the gender ratio remained over 1.50:1.Enterovirus 71 (EV71) and coxsackie virus A16 (CoxA16) dominated common cases, while the severe cases and death cases were mainly infected with EV71.Conclusion Hand-foot-mouth disease has obvious season, population and region characteristics in Yangluo of Wuhan.EV71 and CoxA16 are the main pathogens of common cases, and dominate strains are different in different year.Both severe cases and death cases are mainly infected with EV71.%目的：探讨武汉市阳逻地区2008至2012年儿童手足口病流行病学和病原学特征，为手足口病的防治提供科学依据。方法收集2008至2012年在湖北省中山医院阳逻院区儿科治疗的874例手足口病病案资料，对其进行描述性流行病学方法分析。结果在874例手足口病例中，男584例，女290例。2008至2011年武汉阳逻地区手足口病发病人数呈逐年上升趋势（χ2＝36．54，P＜0．001），2012年有所下降。发病高峰集中在4～9月份；发病年龄以5岁以下幼儿为主；发病人群以散居儿童或幼托儿童为主。2011年报告的病重率明显高于其它年份（χ2＝16．92，P＜0．001）。男性儿童发病率高于女性儿童，每年性别比平均维持在1．50：1以上。普通病例为肠道病毒71型（EV71）和柯萨奇病毒A16型（coxA16）共同主导流行。重症和死亡病例以EV71为流行优势株。结论武汉市阳逻地区手足口病流行有明显季节性、人群性以及地区性，引起手足口病普通病例流行的病原体主要为EV71和CoxA16，且不同年份流行优势株有所不同，重症病例和死亡病例的流行优势毒株均为EV71。