| 任敏睿,崔金朝,聂陶然,刘凤凤,孙军玲,张业武,常昭瑞.2008-2018年中国手足口病重症病例流行病学特征分析[J].中华流行病学杂志,2020,41(11):1802-1807 |
| 2008-2018年中国手足口病重症病例流行病学特征分析 |
| Epidemiological characteristics of severe cases of hand, foot, and mouth disease in China, 2008-2018 |
| 收稿日期:2020-02-01 出版日期:2020-11-25 |
| DOI：10.3760/cma.j.cn112338-20200201-00063 |
| 中文关键词: 手足口病 重症 流行特征 |
| 英文关键词: Hand,foot,and mouth disease Severe case Epidemiological characteristic |
| 基金项目:肠道病毒71型灭活疫苗Ⅳ期临床应用研究（2016ZX09101120-004）；国家科技重大专项（2018ZX10713001）；北京市自然科学基金（L192014） |
| 作者 | 单位 | E-mail | | 任敏睿 | 中国疾病预防控制中心传染病管理处, 传染病监测预警重点实验室, 北京 102206 | | | 崔金朝 | 中国疾病预防控制中心传染病管理处, 传染病监测预警重点实验室, 北京 102206 | | | 聂陶然 | 中国疾病预防控制中心传染病管理处, 传染病监测预警重点实验室, 北京 102206
北京市密云区疾病预防控制中心 101500 | | | 刘凤凤 | 中国疾病预防控制中心传染病管理处, 传染病监测预警重点实验室, 北京 102206 | | | 孙军玲 | 中国疾病预防控制中心传染病管理处, 传染病监测预警重点实验室, 北京 102206 | | | 张业武 | 中国疾病预防控制中心信息中心, 北京 102206 | | | 常昭瑞 | 中国疾病预防控制中心传染病管理处, 传染病监测预警重点实验室, 北京 102206 | changzr@chinacdc.cn |
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| 中文摘要: |
| 目的 了解我国2008-2018年手足口病重症病例的流行病学特征，为重症手足口病的防控提供依据。方法 从中国疾病预防控制中心传染病报告信息管理系统中获取2008-2018年所有手足口病重症病例个案资料，采用描述性流行病学方法分析手足口病重症病例的三间分布、病原构成及变化，采用Joinpoint回归模型分析重症率、重症比例和重症病死率的变化趋势。结果 2008-2018年全国手足口病重症病例157 065例，年均重症率为1.05/10万，重症比例为0.76%，重症病死率为2.34%，重症率和重症比例2010年后出现下降趋势，重症病死率2014年后显著下降。重症病例男性高于女性（1.78：1），以≤3岁婴幼儿为主（91.47%），EV-A71引起的重症手足口病中位年龄最高（1.99岁）且逐年升高，其他肠道病毒感染在≤1岁婴儿中构成较高（66.56%）。4-7月为主要的发病高峰，2018年其他肠道病毒代替EV-A71成为优势血清型（61.97%）。西南部、中部及东部地区部分省份为手足口病重症病例高发省份。结论 我国大陆地区手足口病重症率、重症比例及重症病死率整体呈下降趋势，部分省份优势病原由EV-A71转为其他肠道病毒，应加强重点人群、高发季节、区域防控工作，开展多种手足口病病原监测。 |
| 英文摘要: |
| Objective To characterize the epidemiology of severe hand, foot and mouth disease (HFMD) in China from 2008 to 2018 and provide evidence for the prevention and control of severe HFMD. Methods The incidence data of severe HFMD cases from 2008 to 2018 were collected from the National Notifiable Infectious Diseases Reporting System of Chinese Center for Disease Control and Prevention. Descriptive epidemiological methods were used to analyze distributions, pathogen constituent and change of severe HFMD. Joinpoint regression model was used to analyze the trends of severity rate, proportion of severe cases and severe fatality rate. Results From 2008 to 2018, a total of 157 065 cases of severe HFMD were reported in China, with an average annual case-severity rate of 1.05/100 000, a severe case proportion of 0.76% and a severity-fatality rate of 2.34%. The severity rate and the proportion of severe cases showed a downward trend after 2010, and severe fatality rate decreased significantly after 2014. The severe cases mainly occurred in infants aged ≤3 years (91.47%), more boys were affected than girls (1.78:1). The median age of severe HFMD cases caused by EV-A71 was highest (1.99 years) and increased year by year, other enterovirus infection cases accounted for a higher proportion in infants aged ≤1 year (66.56%). The incidence peak occurred during April-July, other enteroviruses replaced EV-A71 as the predominant serotype in 2018 (61.97%). The incidence of severe HFMD were high in some provinces in southwestern, central and eastern China. Conclusion The overall severity rate, proportion of severe cases and severe fatality rate of HFMD in the mainland of China have shown a downward trend. The predominant pathogen in some provinces has changed from EV-A71 to other enteroviruses. It is necessary to strengthen the prevention and control of HFMD in key population, high incidence seasons and areas and carry out the surveillance of various pathogens of HFMD. |
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