上海儿童手足口病基于人群的健康影响。

The population-based health effect of hand, foot and mouth disease in children in Shanghai.

作者信息

Xu Zhiyin, Shen Huiguo, Wang Zhonglin, Altmeyer Ralf, Xia Aimei, Mao Shenghua, Zhen Yaxu, Li Weixi, Zhao Yanping, Su Hualin, Zhan Longwen, Wang Xiaohong, Pan Hao, Hu Jiayu, Zeng Mei

机构信息

From the *Department of Infectious Diseases, Children's Hospital of Fudan University; †Department of Infectious Diseases, Minhang District Center For Disease Control and Prevention; ‡Institut Pasteur Shanghai, Chinese Academy of Sciences; and §Department of Infectious Diseases and Control, Shanghai Municipal Center For Disease Control and Prevention, Shanghai, China.

出版信息

Pediatr Infect Dis J. 2014 May;33(5):448-52. doi: 10.1097/INF.0000000000000136.

DOI:10.1097/INF.0000000000000136

PMID:24153009

Abstract

BACKGROUND

An effective enterovirus 71 (EV71) vaccine is needed to control the annual outbreaks of hand, foot and mouth disease (HFMD) in China. Adequate epidemiologic data relating to HFMD are needed to make decisions about appropriate public health interventions and implementation of the new EV71 vaccine.

METHODS

We analyzed the population-based epidemiologic characteristics, clinical outcome and laboratory investigation of the 2011 HFMD outbreak in children based on the citywide surveillance system in Shanghai.

RESULTS

The incidence rate of HFMD was 25.8 per 1000 in children <10 years of age in Shanghai in 2011, ranging from 2.5 per 1000 in the age group 7 to 9.9 years to 48.4 per 1000 in the age group 3 to 3.9 years. Children 1 to 1.9 years were at the highest risk of developing severe complications and most susceptible to HFMD. Boys and migrant children had significantly increased risks of contracting HFMD and developing severe disease. More institutional clusters/outbreaks occurred in the winter peak months than in the summer peak months. Migrant young children played a central role in the spread of HFMD in the community. EV71 was identified in 39.7% of mild HFMD outpatients, 47.4% of hospitalized patients, 92.1% of severe inpatients with complications, 50% of outbreaks and 38.8% of clusters in institutions.

CONCLUSION

HFMD and EV71 infections have a significant health effect on Shanghai children.

摘要

背景

在中国，需要一种有效的肠道病毒71型（EV71）疫苗来控制手足口病（HFMD）的年度暴发。需要有足够的手足口病流行病学数据，以便就适当的公共卫生干预措施和新型EV71疫苗的实施做出决策。

方法

我们基于上海市全市范围的监测系统，分析了2011年儿童手足口病暴发的人群流行病学特征、临床结局及实验室检查情况。

结果

2011年上海市10岁以下儿童手足口病发病率为每1000人25.8例，7至9.9岁年龄组为每1000人2.5例，3至3.9岁年龄组为每1000人48.4例。1至1.9岁儿童发生严重并发症的风险最高，且最易感染手足口病。男孩和流动儿童感染手足口病及发生重症疾病的风险显著增加。冬季高峰月份发生的机构聚集性疫情/暴发比夏季高峰月份更多。流动幼儿在社区手足口病传播中起核心作用。在39.7%的轻症手足口病门诊病例、47.4%的住院病例、92.1%的伴有并发症的重症住院病例、50%的疫情及38.8%的机构聚集性疫情中检测到EV71。