The enterovirus 71 epidemic in 2008-public health implications for Hong Kong
The enterovirus 71 epidemic in 2008-public health implications for Hong Kong
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DOI：
10.1016/j.ijid.2010.02.2265
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发表时间：
2010-09-01
影响因子：
8.4
通讯作者：
Chuang, Shuk Kwan
中科院分区：
文献类型：
--
作者：
Ma, Edmond;Chan, King Chun;Chuang, Shuk Kwan
目的：方法：对2008年与过去10年肠道病毒71型（EV 71）病例的流行病学、临床和实验室特征进行比较。我们回顾了病例的临床和流行病学资料。将并发症和病死率（CFR）与1998-2007年期间相应的平均发生率进行比较。结果：EV 71在一般人群中的年发病率为1.4/10万，其中5岁以下儿童的发病率最高（27.9/10万）。季节高峰出现在5月至7月。大多数（92.9%）表现为手足口病（90.8%）或疱疹性咽峡炎，11.2%有并发症，包括脑膜炎或脑炎（6.1%）、肺炎（3.1%）、急性弛缓性麻痹（1.0%）和休克（1.0%）。CFR为1.0%。近一半（45.9%）的学龄病例在其学校/机构同时发生手足口病爆发。与过去十年相比，并发症发生率和CFR无统计学显著差异。分子生物学分析表明，大多数为C4基因组菌株，与过去流行的菌株相似。结论：周期性高活性已产生了重大的公共卫生和社会影响。为加强公共卫生监察及控制，政府于2009年将肠病毒71型感染列为法定呈报疾病。(C)2010年国际传染病学会。由爱思唯尔有限公司出版。保留所有权利。
Objectives: We compared the epidemiological, clinical and laboratory characteristics of enterovirus 71 (EV71) cases recorded in the epidemic year of 2008 with those of the past decade.Methods: We estimated the annual incidence rates in the general population and in different age groups. We reviewed the clinical and epidemiological information of the cases. The complication and case fatality rates (CFR) were compared with the corresponding average rates for the period 1998-2007. The molecular strains of EV71 isolates were determined.Results: The estimated annual incidence was 1.4/100 000 in the general population, with the highest incidence (27.9/100 000) reported among children aged under 5 years. The seasonal peak occurred from May to July. The majority (92.9%) presented with hand-foot-mouth disease (HFMD; 90.8%) or herpangina, and 11.2% had complications including meningitis or encephalitis (6.1%), pneumonia (3.1%), acute flaccid paralysis (1.0%), and shock (1.0%). The CFR was 1.0%. Nearly half (45.9%) of school-aged cases had concurrent HFMD outbreaks at their schools/institutions. There was no statistically significant difference in the complications rate and CFR when compared to those of the past decade. Molecular analysis showed that the majority were genogroup C4 strains, similar to the past circulating strains.Conclusions: The cyclical high activity has had significant public health and social implications. To strengthen public health surveillance and control, EV71 infection was made a statutory notifiable disease in 2009. (C) 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.