内科

目的了解广西灵山县手足口病流行病学特点及其重症病例发生情况，为制定手足口病防控措施提供科学依据。方法收集2012～2014年《中国疾病预防控制信息系统》中灵山县全县手足口病实时报告资料，对全县报告的所有重症病例进行现场流行病学个案调查，对数据进行描述性统计分析。结果广西灵山县2012～2014年手足口病总发病率为133.85/10万，重症所占比例为4.16%；2012、2013、2014三年发病率分别为88.71/10万、112.96/10万、203.54/10万，有逐年升高的趋势。病例集中发生于每年5～11月，最高为9月份，达20.38/10万；男性发病率为167.48/10万，重症所占比例为4.21%；女性发病率为97.31/10万，重症占比例为4.06%；男性发病率高于女性，重症所占比例差别不大。1～2岁儿童发病率最高，发病率分别达到2 072.28/10万、1 345.41/10万，然后逐岁减少。城市和农村发病率分别为156.58/10万和131.17/10万，差别不大；重症占比例分别为0.66%和4.65%，农村高于城镇。病原学检测发现以肠道病毒EV71型为主，占60.30%；但2013年EV71型仅占6.85%，当年重症占比例也最低。结论广西灵山县手足口病发病率具有逐年上升的趋势，病例主要集中在夏秋季、1～2岁儿童发病率最高，病原体以EV71为主，农村重症患者比例明显高于城镇，重症患者比例与当年EV71的占比呈正相关。为有效降低手足口病发病率、减少重症病例的发生，应加强病原学监测，加强农村地区的防控力度。

ObjectiveTo investigate the epidemiological characteristics of hand-foot-mouth disease, and the occurrence of severe cases in Lingshan County, and provide scientific evidence for the prevention and control of HFMD. MethodsThe data of HFMD of Lingshan County from “Information system of disease prevention and control of China”during 2012 to 2014 was collected. Field epidemiology investigation of all severe cases were performed, and the data were analyzed by descriptive statistics. ResultsFrom 2012 to 2014, the total incidence rate of HFMD was 133.85/100 000, the proportion of severe cases was 4.16% in Lingshan County; the incidence rates of HFMD in 2012, 2013 and 2014 were 88.71/100 000, 112.96/10 000 and 203.54/100 000, respectively, and the incidence rate was increasing year by year.Cases of HFMD was concentrated from May to November, peaked in September (20.38/100 000);the rate of HFMD of males was 167.48/100000, severe cases accounted for 4.21%, and in the females, the total incidence rate was 97.31/100 000 with 4.06% of the proportion of severe cases, the incidence rate of male was higher than that of female, but little difference in the proportion of severe cases between male and female. The highest incidence rate was at the age during 1-2 year old, which reached to 2072.28/100 000 and 1345.41/100 000, respectively, and then the rate decreased by age.The incidence rates of urban and rural were 156.58/100000 and 131.17 /100 000,respectively, with little difference between the two ,but the proportion of the severe in rural areas (0.66%) was higher than that of urban (4.65%). The results of pathogenic detection showed that the intestinal virus EV71 was the main pathogens ,which accounted for 60.30% , but it accounted for only 6.85% in 2013, and the proportion of severe cases was also the lowest in this year. ConclusionsThe incidence rate of HFMD was increased year by year in Lingshan County, cases of HFMD was concentrated in Summer and Autumn, and the highest incidence rate was at the age during 1-2 year old, the main pathogen was EV71, the proportion of severe cases in the rural area was higher than that of urban, and the proportion of the severe cases were positively correlated with the proportion of EV71 in present year. We should strengthen the monitoring of pathogens and enhanced the prevention and control of HFMD in rural areas, in order to control the incidence rates and occurrence of severe cases effectively.