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目的了解西双版纳州2008—2010年手足口病的发病率、流行高峰、人群分布及病原构成。方法对2008—2010年疾病监测信息系统报告的手足口病病例进行流行病学特征分析。结果①2008年西双版纳州报告手足口病病例511例,发病率48.21/10万;无重症及死亡病例。2009年报告723例,发病率67.74/10万;重症1例,重症率为0.14%。2010年报告1 013例,发病率94.25/10万;重症3例,重症率0.30%。②2009年流行呈单峰分布,高峰在第16～23周,最高峰在第17周。2010年流行高峰则出现在第37～45周,最高峰在第40周,高峰期明显推后。③2008—2010年病例的年龄分布特点相似,主要集中在3岁以下儿童,占发病总数的64.05%,其中,以1岁年龄组发病率最高。3岁以下发病率为218.96/10万,3～10岁发病率为22.04/10万。发病率之间差异存在统计学意义(χ2=4 100.65,P<0.01)。3岁以下发病率高于3～10岁的发病率。④2010年报告的1 013例病例中,采集标本60份,其中咽拭子52份,粪便标本6份,血清标本2份。使用中国广州安达公司生产的试剂盒进行检测,EV71阳性14例,阳性率23.33%,CoxA16阳性8例,阳性率13.33%。结论 2008—2010年间,2010年手足口病流行强度最强,3岁以下儿童发病率高于3岁以上。EV71流行是导致2010年疫情上升和重症增加的原因。预防控制以农村为重点,采取三级预防模式,包括卫生条件的改善、健康教育、易感人群保护和手足口病疫苗研制等;同时应重视二、三级预防,通过新的检测技术和手段早期发现患者,并给予及时的治疗,以预防和减少并发症的发生。
Objective To understand the incidence, epidemic peak, population distribution and pathogens of hand, foot and mouth disease in Xishuangbanna Prefecture from 2008 to 2010. Methods The epidemiological characteristics of hand, foot and mouth disease reported in the Disease Surveillance Information System from 2008 to 2010 were analyzed. Results ① In 2008, 511 cases of hand-foot-mouth disease were reported in Xishuangbanna Prefecture, with a prevalence of 48.21 / 100 000; no severe cases and deaths were reported. 723 cases were reported in 2009, the incidence rate was 67.74 / 100000; severe cases were 1 cases, severe rate was 0.14%. 1 013 cases were reported in 2010, with an incidence rate of 94.25 / 100 000; severe cases of 3 cases, severe rate of 0.30%. ② 2009 was a single peak distribution, the peak in the first 16 to 23 weeks, the highest peak in the first 17 weeks. The peak in 2010 appeared in the 37th to 45th week, with the peak dropping at 40th week. ③ The age distribution characteristics of the cases in 2008-2010 are similar, mainly in children under 3 years old, accounting for 64.05% of the total number of cases, of which the highest incidence was in the age group of 1 year. The incidence of under 3 years old was 218.96 / 100000, the incidence of 3 to 10 years old was 22.04 / 100000. The difference between the incidence of statistical significance (χ2 = 4 100.65, P <0.01). The incidence of 3 years of age is higher than the incidence of 3 to 10 years old. ④ Of the 1,013 cases reported in 2010, 60 samples were collected, of which 52 were throat swabs, 6 stool samples and 2 serum samples. Using the kit produced by Guangzhou Anadu, China, 14 patients were EV71 positive with a positive rate of 23.33% and a positive rate of CoxA16 of 13.33%. Conclusion During 2008-2010, the intensity of HFMD was the strongest in 2010 and the incidence of children under 3 years old was higher than that of 3 years old. The EV71 epidemic is responsible for the rising and severe increase in 2010. Prevention and control should focus on the rural areas and adopt a three-level prevention model, including improvement of sanitation conditions, health education, protection of susceptible people and development of HFMD vaccines. At the same time, secondary and tertiary prevention should be emphasized and new testing techniques and measures Early detection of patients, and give timely treatment to prevent and reduce the incidence of complications.