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目的掌握广东省既往病毒性脑炎发病的本底情况及流行特征。方法 2012年6月,对广州、佛山、肇庆、云浮、茂名、梅州、汕头市辖区内的所有县(区)级及以上综合医院、妇幼保健院(儿童医院)等共141间医疗机构开展2009-2011年收治病毒性脑炎病例情况回顾调查。结果调查的141间医疗机构有93间医疗机构共收治病毒性脑炎病例7 259例,死亡227例,总的病死率为3.13%。2009-2011年7个市发病率的中位数分别为4.89/10万、5.14/10万和4.75/10万。病例发病高峰在每年的5-7月;病例主要分布在15岁以下儿童,占57.60%(4 181/7 259),其中,5岁以下儿童占57.12%(2 388/4 181)。死亡病例主要以15岁以下儿童为主,占76.21%(173/227)。208例为明确病原体的病例占全部病例的2.87%(208/7 259);其中,前三位的病原体分别为肠道病毒、EB病毒和乙型脑炎病毒。结论广东省病毒性脑炎有春夏季流行高峰,高发人群及病死率高的人群均为15岁以下儿童,建议在全省设置哨点医院,重点开展15岁以下儿童病毒性脑炎监测。
Objective To understand the background and prevalence of previous viral encephalitis in Guangdong Province. Methods In June 2012, a total of 141 medical institutions in Guangzhou, Foshan, Zhaoqing, Yunfu, Maoming, Meizhou and Shantou were enrolled in a total of 141 medical institutions, including general hospitals, maternal and child health centers (children’s hospitals) Retrospective survey of cases of viral encephalitis admitted in 2011. Results A total of 7 259 cases of viral encephalitis were treated in 93 medical institutions in 141 medical institutions surveyed with 227 deaths and the overall case fatality rate was 3.13%. The median incidence of seven municipalities in 2009-2011 was 4.89 / 100,000, 5.14 / 100,000 and 4.75 / 100,000, respectively. The incidence peaked from May to July of each year. The cases mainly distributed in children under 15 years old, accounting for 57.60% (4 181/7 259), of which 57.12% (2 388/4 181) were below 5 years of age. The majority of deaths were children under 15, accounting for 76.21% (173/227). Among 208 cases with clear pathogens accounted for 2.87% (208/7 259) of the total cases, the top three pathogens were enterovirus, Epstein-Barr virus and Japanese encephalitis virus respectively. Conclusions The viral encephalitis in Guangdong Province has the peak of spring and summer epidemic. The high incidence population and high mortality rate are all children under 15 years old. It is suggested that a sentinel hospital should be set up in the province to monitor viral encephalitis in children under 15 years old.