EV71型病毒疫苗接种后住院患儿手足口病流行病学特征及病原学变化

Epidemiological characteristics and change in pathogens of hand-foot-and-mouth disease in hospitalized children after EV71 vaccination

摘要:

目的 了解 EV71型病毒疫苗接种对手足口病流行病学及病原学的影响,为手足口病的防治工作提供科学依据。方法 收集2014—2018年某院手足口病住院患儿病例资料,应用SPSS 18.0软件对数据进行统计,比较EV71型病毒疫苗接种前后(2014年—2016年10月 VS 2016年11月—2018年)住院患儿手足口病的流行病学特征及病原学变化。结果 共收治手足口病住院患儿7 099例,其中普通型6 339例,重症1 570例。与 EV71型病毒疫苗接种前比较,接种后手足口病住院患儿数减少,重症病例所占比率下降,差异有统计学意义(χ²=56.27,P<0.001)。男童患病率高于女童,发病年龄仍然以5岁以下婴幼儿为主,但每个年龄段重症病例均有下降;全年发病呈现两个高峰,分别在5—7月、9—11月;普通型病例以非EV71/CoxA16肠道病毒感染为主,重症病例仍以EV71型病毒感染为主。结论 EV71型病毒疫苗接种后手足口病优势病原体较前发生了明显变化,且重症病例所占比率明显下降,EV71型病毒疫苗值得推广应用。需进一步开展非EV71/CoxA16肠道病毒的分型检测,为手足口病的防治提供更加有力的依据。

Abstract:

Objective To understand the effect of EV71 vaccination on the epidemiology and pathogen of hand-foot-and-mouth disease (HFMD), and provide scientific basis for the prevention and treatment of HFMD. Methods Data of children with HFMD in a hospital from 2014 to 2018 were collected, SPSS 18.0 software was used to analyze the data, epidemiological characteristics and change in pathogens of HFMD in hospitalized children before and after EV71 vaccination were compared. Results A total of 7 099 children with HFMD were admitted in the hospital, including 6 339 cases of common type and 1 570 cases of severe type, compared with children before EV71 vaccination, the number of hospitalized children with HFMD after vaccination decreased, proportion of severe cases decreased (χ²=56.27, P<0.001). Incidence of HFMD in boys was higher than girls, onset age was still dominated by infants under 5 years old, but the number of severe cases in each age group all decreased; there were two onset peaks in the whole year, which was May-July and September-November respectively; common cases were mainly EV71/CoxA16 infection, while severe cases were mainly EV71 infection. Conclusion The dominant pathogen of HFMD changes significantly after EV71 vaccination, and proportion of severe cases decrease significantly, EV71 vaccine is worth to be popularized and applied. In order to provide a more powerful basis for the prevention and treatment of HFMD, it is necessary to further develop the typing detection of non-EV71/CoxA16 enteroviruse.