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目的分析2015-2016年德阳市儿童肠道病毒71型(EV71)感染手足口病(HFMD)的流行病学情况,为制定有效的干预措施提供理论依据。方法采用逆转录-聚合酶链反应(RT-PCR)技术检测2015-2016年在德阳市定点医院门诊或住院的1 290例HFMD患儿的咽拭子标本,了解肠道病毒类型,并分析EV71感染HFMD的流行病学特征。结果 1 290例咽拭子标本中共检出779株肠道病毒分离物,占60.39%,EV71阳性率为30.16%(389/1 290)。2015年和2016年EV71感染HFMD发病率比较,差异有统计学意义(P<0.05);2015年发病高峰主要集中在5~7月,10月有另一个小高峰,2016年发病高峰集中在5~8月。2015年和2016年EV71感染HFMD患儿发病年龄均集中在1~4岁;2015年和2016年男童EV71感染HFMD发病率明显高于女童,差异有统计学意义(P<0.05)。2015年和2016年本市人口EV71感染HFMD发病率低于外来人口,差异有统计学意义(P<0.05),但2015-2016年本市人口发病率明显上升。儿童发病地点为家里的几率高于幼儿机构,差异有统计学意义(P<0.05)。389例HFMD患儿中,单纯HFMD 249例(64.01%),HFMD合并支气管肺炎72例(18.51%),HFMD合并心肌损伤8例(2.06%),HFMD合并脑炎51例(13.11%),疱疹性咽峡炎9例(2.31%);临床症状以不同程度发热(73.26%),口腔疱疹症状(78.41%),皮肤(手、足、躯干等)出疹较为常见(92.80%)。结论 EV71感染HFMD的发病高峰期为5~8月,1~4岁、男童、外来人口为易感人群,家里为发病高发地,临床症状以发热、皮疹为主。根据以上流行特点,重视培养看护人和儿童良好卫生习惯及为儿童提供良好生活环境对预防HFMD发生有重要意义。
Objective To analyze the epidemiological status of HFMD in children with EV71 infection in Deyang from 2015 to 2016 and provide a theoretical basis for effective intervention. Methods Throat swab samples of 1,290 children with HFMD who were hospitalized or hospitalized in Dingyang Hospital of Deyang from 2015 to 2016 were detected by reverse transcription-polymerase chain reaction (RT-PCR) to understand the type of enterovirus and EV71 Epidemiological characteristics of HFMD infection. Results A total of 779 enterovirus isolates were detected in 1 290 throat swab specimens, accounting for 60.39%. The positive rate of EV71 was 30.16% (389/1 290). The prevalence of HFMD in EV71 infected in 2015 and 2016 was significantly different (P <0.05). The peak incidence in 2015 was mainly concentrated in May-July, and there was another small peak in October. The peak incidence in 2016 was 5 ~ August. The incidence of HFMD in children with EV71 infection in 2015 and 2016 were all between 1 and 4 years old. The prevalence of HFMD in EV71 children in 2015 and 2016 was significantly higher than that in girls (P <0.05). The prevalence of HFMD in this city was lower than that of the non-native population in 2015 and 2016 (P <0.05), but the incidence of HFMD in this city was significantly increased from 2015 to 2016. The incidence of children at home was higher than that of child care institutions, the difference was statistically significant (P <0.05). Of the 389 HFMD patients, 249 (64.01%) had HFMD alone, 72 (18.51%) had HFMD with bronchopneumonia, 8 (2.06%) had HFMD with myocardial injury, 51 (13.11%) had HFMD with encephalitis, 9 cases were angina (2.31%); clinical symptoms were more common (92.80%) with different degrees of fever (73.26%), oral herpes symptoms (78.41%) and skin (hands, feet and torso) Conclusions The peak incidence of HFMD infected with EV71 is from May to August, 1 to 4 years old. Boys and migrants are susceptible. The incidence of HFMD is high in the family. The clinical symptoms are fever and rashes. According to the above popular features, attention to developing caregivers and children’s good hygiene practices and providing a good living environment for children are of great significance in preventing the occurrence of HFMD.