| 摘要: | 研究目的：利用現有之腸病毒相關之資料庫進行地區時序分析，以評估腸病毒傳播路線模式，期能據此模式推估腸病毒之流行趨勢。研究方法：利用住院、門診及監測和定點醫師通報資料分析發生或盛行之性別年齡分布，年代趨勢季節(月份)變化，進而比較六大地區發生時序以觀察傳播路線。由門診及住院資料依六大地區分析每年的週或月別發生或盛行狀況，辨別病例數上升快速之月份及地區，以相對人數分辨各縣市暴發次序。挑出各月份上升最快的地區，然後觀察其他地區之病例變化，區別腸病毒擴散之模式。分析腸病毒患者檢體的陽性率分布和各地區定點醫師的平均通報病例數，包括手足口病和疱疹咽峽炎。主要發現：由2000年到2004年的住院資料顯示，腸病毒最盛行的月份是五月，且以中部地區人數最多；但是重症總人數則以南部稍高於中部地區，由五年平均重症率比較，南部地區有稍高的現象。病例檢體分析顯示，腸病毒檢出的陽性率(換算為9歲以下的人口)南部最高，為9.0/10000，中部地區居次為8.2 /10000，遠高於台北縣市的2.7/10000。定點醫師的通報數則以中部地區的最高，尤其是疹疱性咽峽炎；由流行曲線觀察，中部有先流行的現象，但南部在次年也有早發生的傾向，一般而言北部尤其是台北縣市每年發生的現象較晚，腸病毒檢出率也較低。結論：腸病毒的流行以中南部較盛行，中部的通報數較高，有先出現流行的傾向，南部稍晚流行，但檢體分析的陽性檢出率較高。
Objectives： Using the domestic surveillance database available for enterovirus infection, this study analyzed the patterns of the epidemic of the infection by region and the time. We expected to assess the epidemic curves and identify the index area of epidemic, and disseminate the findings to other areas for prevention. Materials & Methods： We obtained the relevant surveillance data files, from the Centers for Disease Control, including data of hospitalization, ambulatory care, virology lab monitoring records, and sentinel physicians reports. Incidence and prevalence were calculated by sex and age. Seasonality trends were depicted by month and week among six areas to observe the route of infection. We use visual display to distinguish the intensity with which the disease occurred, the month or week with elevated cases or rates, the sequence of epidemic outbreaks among areas. Analyses were conducted separately for the data of hospitalization, ambulatory care, virology lab data and sentinel reports. Results： Based on the data of inpatients from 2000 to 2004, the enterovirus infection was most prevalent in May, in central Taiwan. But the severe complicated cases were the most prevalent in southern areas. In addition, the positive rate of laboratory enterovirus-examination among children under 9 years of age was also the highest in southern areas (9.0 per 10000), and followed by central areas (8.2 per 10000), both rates were approximately three times higher than that in Taipei city and Taipei county (2.7 per 10000). The sentinel physicians in central Taiwan reported more cases than in other areas, with particularly the infections with herpangina. The epidemic curves also showed that the annual epidemic usually started from the central areas. However, the epidemic also had a potential to start from southern areas after a high peak in last fall. In general, the epidemic of enterovirus infection in northern areas occurred about one month behind southern areas with lower positive isolation rate of the specimens. Conclusions： Our study shows that the enterovirus infection in Taiwan is more prevalence in central and southern areas. The sentinel physicians in central areas reported more cases of the infection and the epidemic stared earlier in central areas. However, the positive isolation rate of the specimen was slightly higher in southern areas than in central areas. |
