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目的揭示深圳市2009-2013年手足口病聚集性疫情的流行特征,为开展更加科学有效的防控措施提供依据。方法通过深圳市疾病控制信息管理系统和国家突发公共卫生事件报告管理信息系统获取疫情信息,采用描述性流行病学方法进行分析。结果 2009-2013年深圳市共报告手足口病聚集性疫情365起,占同期全部传染病聚集性疫情的21.1%(365/1727),其中16起符合突发公共卫生事件标准,占同期全部传染病类突发公共卫生事件的6.8%(16/236)。聚集性疫情高峰集中在3-6月(66.6%,243/365);主要发生在托幼机构93.7%(342/365);原特区内地区占68.2%(249/365),但突发公共卫生事件主要发生在原特区外(11/16)。疫情发生后1天内报告的占38.6%(141/365);罹患率为0.59%~100%,中位数为10.3%;持续时间为1~41 d,中位数为3.0 d。疫情发生报告间隔与疫情持续时间和发病人数均呈正相关(r分别为0.621和0.416,P均<0.05)。2009年和2010年肠道病毒71型(EV71)为优势毒株,各占39.5%、48.4%,2011年EV71、柯萨奇病毒A组16型(Cox A16)和其他肠道病毒,各占27.6%、23.5%和22.4%,2012年和2013年其他肠道病毒为优势毒株,各占39.4%和28.2%。结论手足口病聚集性疫情调查处置可有效减少突发公共卫生事件的发生。深圳市报告的手足口病聚集性疫情主要发生在托幼机构,3-6月为高发期,应加强原特区外地区的报告管理工作,及时报告处置是控制疫情的关键。
Objective To reveal the epidemiological characteristics of HFMD in Shenzhen from 2009 to 2013 and provide evidence for more scientific and effective prevention and control measures. Methods Epidemic information was obtained from Shenzhen Disease Control Information Management System and National Public Health Emergencies Reporting Management Information System. Descriptive epidemiological methods were used to analyze the epidemic situation. Results A total of 365 HFMD cases were reported in Shenzhen from 2009 to 2013, accounting for 21.1% (365/1727) of the total infectious disease outbreaks in the same period. Among them, 16 were in line with public health emergencies standards and accounted for the total number of infections 6.8% of public health emergencies (16/236). The peak of the cluster epidemic concentrated in March-June (66.6%, 243/365), mainly in child-care institutions 93.7% (342/365), and in the original SAR area accounting for 68.2% (249/365) Health incidents occurred mainly outside the original SAR (11/16). The reported incidence was within one (1) day of the outbreak (38.6% (141/365)). The attack rate was 0.59% -100% with a median of 10.3%. The duration was from 1 to 41 days with a median of 3.0 days. The reporting intervals of outbreaks were positively correlated with the duration of the epidemic and the number of the outbreaks (r = 0.621 and 0.416, respectively, P <0.05). In 2009 and 2010, enterovirus 71 (EV71) was the predominant strain, accounting for 39.5% and 48.4% respectively, EV71 and Cox A16 in 2011 and other enteroviruses 27.6%, 23.5% and 22.4% respectively. Other enteroviruses were the dominant strains in 2012 and 2013, accounting for 39.4% and 28.2% respectively. Conclusion Investigation and disposal of aggregated epidemic situation of hand-foot-mouth disease can effectively reduce the incidence of public health emergencies. The reported HFMD epidemic in Shenzhen mainly occurred in nurseries and kindergartens, and from March to June was the high incidence period. Report management should be strengthened in areas outside the original SAR. The timely reporting and disposal are the key points for controlling the epidemic.