The Epidemiological Characteristics Of Hand-foot-mouth Disease In Huishan District Of Wuxi City During 2012 To 2016

Objective:Hand-foot-mouth disease(HFMD)is a viral infectious disease in children caused by kinds of human enteroviruses and is highly prevalent in children.There are no specific drugs and preventive measures for HFMD at present,but the incidence of HFMD has increased and spread.In order to understand and master the epidemiological and pathogenic characteristics of HFMD in Huishan District of Wuxi City,in order to understand and master the epidemiological and pathogenic characteristics of HFMD in Huishan District of Wuxi City,surveillance of HFMD was carried out from 2012 to 2016 for the area,and the incidence trend and main pathogens were analyzed in order to grasp the characteristics of HFMD,high incidence crowd and the key sites for its occurrence.So that timely measures should be taken to prevent the spread of the epidemic,reduce the occurrence of the disease,especially the occurrence and death of severe cases,and provide reference for the health administrative departments to formulate prevention and control strategies.Methods:Descriptive epidemiological surveillance method was used to investigate the incidence,high incidence crowd and the key sites of HFMD in Huishan District of Wuxi City from 2012 to 2016.At the same time,the pathogenic characteristics of HFMD were monitored and analyzed.Epidemic characteristics were described by time distribution,crowd distribution and regional distribution,and pathogenic characteristics were described by virus population type.Chi-square test was used to analyze the counting data.Results:A total of 11379 cases of HFMD were reported in Huishan District duiring 2012 to 2016,with an average annual reported incidence of 285.93/100,000 in five years.The incidence of male was 342.48/100,000,and that of female was 230.61/100,000.The sex ratio of male and female was 1.45:1.There was a statistical difference in the incidence of male and female(?2=436.64,P<0.001).April to July and October to December of each year were the main and secondary peaks of the disease,accounting for 56.29%and 23.52%of all cases respectively.The incidence of the disease was mainly concentrated in the age group of 5 years and below,accounting for 91.72%of all cases,and mainly in scattered children and kindergarten children(94.60%).A total of 150 severe cases were reported during the five-year period.The time distribution of severe cases was basically the same as that of common cases.Severe cases were all infants aged 5 years old and younger,and 76.00%of them were aged 3 years old and younger,which was the main age group of onset.The proportion of scattered and kindergarten children was the largest,accounting for 97.33%of all severe cases.Among the severe cases,Qianqiao Street,Yanqiao Street,Luoshe Town and Chang'an Street were the top four areas,accounting for 83.33%of the total reported cases.There were regional differences in the incidence of severe diseases among townships or streets(?2=25.82,P<0.001).From 2012 to 2016,there were 248 reports of cluster epidemics in Huishan District,of which 183 cases were reported by nurseries and kindergartens,accounting for 73.79%of the total number of epidemic reports;6 outbreaks occurred in nurseries and kindergartens,including 3 in 2013,2 in 2014 and 1 in 2016 respectively.The incidence peak of cluster epidemics was basically consistent with that of common cases,and the outbreaks also occur during the two peak periods.In 2012-2016,a total of 1088 cases of HFMD were collected for pathogen surveillance,of which 938 were common cases and 150 were severe cases.Among them,606 cases were laboratory confirmed cases,and the positive rate was 55.70%.The results of laboratory surveillance showed that the viral population types of common and severe cases were different.Enterovirus 71(EV71)and CoxA16(CoxA16)were the main viral population types of common cases,and the positive rate of etiological test was 54.48%;however,the virus population type of severe cases was dominated by EV71,and the positive rate of pathogenic test results was 63.33%in severe cases.There was a statistically significant difference in the total positive rate of virus detection between the two(?2=4.11,P<0.05).The proportion of EV71 type in patients with positive pathogen detection was up to 86.32%in severe cases,which was more than twice as high as 42.27%in common cases(?2=65.09,P<0.001),suggesting that the dominant strain of pathogen population type was EV71 in severe cases.Conclusion:The key population with a high incidence of HFMD in Huishan District was children,and it was mainly distributed in the specific population of scattered children aged 5 years and below and children in preschool,and childcare institutions were the important places of HFMD occurrence.Its incidence has fluctuation and seasonal rule,and the distribution of age,sex and area is also different.The common cases were different from the severe cases in the pathogenic characteristics.The pathogens of common cases are mainly EV71 and Cox A16 viruses,while the main pathogen of severe cases was EV71 virus.It was suggested that attention should be paid to the routine monitoring of HFMD,especially the formulation of prevention and control strategies for key populations and institutions,so that we can investigate and dispose in time to control the incidence of the disease and prevent the occurrence or spread of the epidemic.