| 樊欢,符院生,单军,施超,张雪峰,霍翔,鲍昌俊,嵇红.江苏省3个城市2012-2015年手足口病聚集性与暴发疫情监测分析[J].中华流行病学杂志,2016,37(12):1608-1614 |
| 江苏省3个城市2012-2015年手足口病聚集性与暴发疫情监测分析 |
| Surveillance on the epidemiological and etiological characteristics of hand-foot-mouth disease during the outbreaks in three cities of Jiangsu province, 2012-2015 |
| 收稿日期:2016-06-16 出版日期:2016-12-12 |
| DOI：10.3760/cma.j.issn.0254-6450.2016.12.011 |
| 中文关键词: 手足口病 疫情 聚集性 暴发 监测 |
| 英文关键词: Hand-foot-mouth disease Epidemic Cluster Outbreak Surveillance |
| 基金项目:国家青年自然科学基金（81402732）；重大新发传染病综合防控科技示范工程（BE2015714）；无锡市科技局科技发展项目（CSE31N1515） |
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| 中文摘要: |
| 目的 分析江苏省无锡、常州、连云港3个城市2012-2015年手足口病聚集性和暴发疫情的流行病学特征及其影响因素，为全省手足口病的防控提供科学依据。方法 依据《手足口病聚集性和暴发疫情处置工作规范（2012版）》，主动收集3个城市2012-2015年手足口病聚集性和暴发疫情资料，实验室确认试验采用荧光定量RT-PCR 方法，分析描述疫情的时间、地区、场所分布及其规模，采用logistic回归模型分析疫情罹患率和持续时间的影响因素。结果 2012-2015年3个城市共报告手足口病疫情1 425起（其中聚集性疫情1 314起，暴发疫情111起）。发病时间主要集中在每年3-6月和9-12月，分别占58.18%（829/1 425）和33.68%（480/1 425）；无锡市报告的疫情较多，占59.30%（845/1 425）；疫情场所主要在托幼机构，占68.63%（978/1 425）。931起聚集性和暴发疫情经实验室确认试验显示，2012年、2014年以肠道病毒71型（EV71）和柯萨奇病毒A组16型（Cox A16）两种病毒株主导流行，2013年、2015年分别以单一病毒株EV71和Cox A16为优势毒株。多因素logistic回归分析结果显示，疫情的罹患率与周围环境卫生状况有关，卫生状况越好，罹患率越小（中 vs. 差：OR=0.150，95%CI：0.034～0.667；好 vs. 差：OR=0.072，95%CI：0.016～0.317）；疫情持续时间与报告的及时性有关，报告时间越晚，疫情的持续时间越长（4～7 d vs. 1～3 d：OR=3.452，95%CI：2.293～5.198；8 d vs. 1～3 d：OR=12.108，95%CI：7.767～18.763）。结论 江苏省3个城市手足口病聚集性和暴发疫情的时间特征呈现双峰分布，病毒型别存在年份差异，托幼机构是疫情主要场所，疫情报告的及时性对控制疫情起关键作用。 |
| 英文摘要: |
| Objective To analyze the epidemiological and etiological characteristics through monitoring the outbreaks of hand-foot-mouth disease (HFMD), in three cities of Jiangsu province from 2012 to 2015 and to provide evidence for prevention and control of the disease. Methods Data related to cases of HFMD during the outbreaks was collected through active surveillance programs in three cities of Jiangsu province, under the guidelines of clusters and outbreaks of HFMD (2012 edition HFMD). Features related to clusters and outbreaks of the disease were identified according to the real-time RT-PCR detection. Descriptive analysis was conducted to understand the type/subtype of HFMD virus and time, area, place and extent of the outbreaks. Logistic regression was used to explore the influencing factors. Results From 2012 to 2015, a total of 1 425 HFMD epidemics, including 1 314 clusters and 111 outbreaks were reported. Two incidence peaks were observed each year, between March and June, as well as between September and December, accounting for 58.18% (829/1 425), 33.68% (480/1 425), respectively. Most HFMD clusters and outbreaks were reported in Wuxi city, accounting for 59.30% (845/1 425) of the total. Most HFMD clusters and outbreaks happened in kindergartens, accounting for 68.63% (978/1 425) of the total. A total of 931 HFMD clusters and outbreaks were confirmed under laboratory findings. The main pathogens were Entervirus type 71 (EV71) in 2013 and Coxsackie A16 (Cox A16) in 2015, respectively, while both EV71 and Cox A16 were predominant in 2012 and 2014. With multivariate backward conditional regression, surrounding environment was identified as important risk factor associated with the attack rate. Health condition of the environment was quite good, with low attack rates (middle vs. bad:OR=0.150, 95%CI:0.034-0.667; good vs. bad:OR=0.072, 95%CI:0.016-0.317). Time between the onset of index patient and the reporting of HFMD clusters or outbreaks was important in the control program of HFMD epidemics (4-7 d vs. 1-3 d:OR=3.452, 95%CI:2.293-5.198; 8 d vs. 1-3 d:OR=12.108, 95%CI:7.767-18.763). Conclusions The clusters and outbreaks of HFMD happened in Jiangsu province showed an obvious feature of seasonality. The predominant types or subtypes of the virus varied in different years. Kindergartens were the hard-hit places of HFMD clusters and outbreaks. Timely report of the disease appeared the key point regarding the control of HFMD clusters and outbreaks. |
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