Analysis on the epidemiological and etiological characteristics of clustered cases of hand, foot, and mouth disease in Wuxi from 2009 to 2014
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摘要: 目的 了解无锡市2009-2014年手足口病聚集性疫情的流行特征,为制定手足口病防控措施提供科学依据。方法 收集2009-2014年无锡市手足口病聚集性疫情信息,应用描述流行病学方法分析三间分布特征。结果 2009-2014年无锡市共报告手足口病聚集性疫情1 035起,累积报告病例4 959例,占同期总发病人数的6.2%(4 959/79 571),其中12起符合突发公共卫生事件标准;聚集疫情每年发病高峰在4~6月和11月;聚集性疫情和病例数均集中在城乡结合部,主要发生在托幼机构77.6%(803/1 035),且地区间托幼场所发生频次分布差异有统计学意义(χ2=128.21,P<0.001);疫情发生后1 d内报告的占21.3%(220/1 035),罹患率为0.02%~100.00%,中位数为1.6%,疫情持续时间1~46 d,中位数为4.0 d;疫情发生报告间隔与疫情持续时间及发病人数均呈正相关(均有P<0.001)。共采集病例标本阳性率为42.2%(1 008/2 389),阳性标本中以EV71型(45.3%)和CoxA16(40.1%)为主。结论 无锡地区城乡结合部的托幼机构是手足口病聚集性疫情高发场所,应加大对托幼机构的监管,可以有效防控手足口病暴发疫情。Abstract: Objective To ascertain the epidemiological characteristics of clustered cases of hand, foot and mouth disease (HFMD) in Wuxi, and to provide scientific basis for the prevention and control of HFMD. Methods Data on clustered cases of HFMD in Wuxi from 2009 to 2014 was collected to conduct descriptive analysis. Results From January 2009 to December 2014, 1 035 HFMD outbreaks affecting 4 959 individuals which accounting for 6.2% of all cases of HFMD were reported in Wuxi, in which 12 were classified as public health emergencies. The annual incidence peak of HFMD occurred during April to June, and sub-peak occurred in November. The majority of outbreaks (48.7%) and cases (48.0%) were concentrated in rural-urban continuum. Up to 77.6% of outbreaks occurred in kindergartens. The occurrence frequency in different districts of kindergartens showed statistical difference (χ2=128.21,P<0.001). A total of 220 outbreaks (21.3%) were reported within one day. The attack rate of which ranged from 0.02% to 100.00% (median: 1.6%), and the durations ranged from one to 46 days (median: 4 days). Correlation analysis indicated that non-timely reporting was positively related with the duration and cases number of the outbreak significantly (all P<0.001), with r value of 0. 627 and 0.219 respectively. Of all cases, 2 389 samples were tested, the positive rate was 42.2% (1 008/2 389). The tests indicated intestinal virus EV71 (45.3%) and CoxA16 (40.1%) were the two dominated types in positive samples. Conclusions Kindergartens of rural-urban continuum are areas with a prevalence of clustered cases of HFMD. Clustered cases of HFMD can be effectively controlled by enhancing surveillance in these kindergartens.
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Key words:
- Hand, foot and mouth disease /
- Disease outbreaks /
- Epidemiologic methods
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