[2010 - 2014年上海市手足口病流行病学监测]

[Epidemiological surveillance of hand, foot and mouth disease in Shanghai, 2010-2014].

作者信息

Ge Yanling, Zheng Yaxu, Pan Hao, Mao Shenghua, Li Yuefang, Xia Aimei, Zhu Qirong, Hu Jiayu, Zeng Mei

机构信息

Department of Infectious Disease, Children's Hospital of Fudan University, Shanghai 201102, China.

Department of Infectious Diseases and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China.

出版信息

Zhonghua Er Ke Za Zhi. 2015 Sep;53(9):676-83.

PMID:26757968

Abstract

OBJECTIVE

To understand the epidemiological profiles of hand, foot and mouth disease (HFMD) and the major enteroviruses causing the epidemics of HFMD in Shanghai from 2010 to 2014.

METHOD

The city-wide surveillance data between 2010 and 2014 were used to analyze the epidemiologic characteristics of the HFMD outbreaks in Shanghai. The annual incidence of HFMD was estimated based on the 2010 Shanghai Census data.

RESULT

From 2010 to 2014, the reported HFMD cases were 41 080, 37 323, 51 172, 42 198, and 65 018, respectively; the severe cases (case-severity ratio) were 469 (1.14%), 456 (1.22%), 318 (0.62%), 104 (0.25%) and 248 (0.38%), respectively. Based on Shanghai census data by the end of 2010, the attack rates of HFMD in Shanghai were 0.16%-0.28% in the entire population. In terms of the proportion of HFMD cases and severe cases in the specific population, male accounted for 59.62%-61.48% and 62.26%-73.08%, migrant population accounted for 51.86%-62.40% and 72.01%-80.38%; children aged 1.0-1.9 years comprised the highest proportion, up to 22.70%-27.00% and 32.08%-36.40%. HFMD peaked from April to July, in parallel with the peak circulation of enterovirus (EV) 71, and a small peak usually occurred in autumn and winter. All the critically severe and fatal cases were caused by EV71. The detection rates of EV71 and Coxsackievirus A (CA) 16 were 73.08%-88.09% and 1.12%-2.90% in severe HFMD cases, 19.75%-48.74% and 2.02%-23.69% in uncomplicated inpatients, and 16.78%-40.08% and 8.36%-33.39% in mild community cases, respectively. The detection rates of CA6 and CA10 in the mild community cases in 2014 were 18.38% and 1.43%, respectively. In 2013 non-EV71 and non-CA16 enteroviruses comprised 74.86% in the community cases.

CONCLUSION

The annual HFMD outbreaks occurred in Shanghai during 2010-2014. Children under 5 years of age, migrant population and male were the major susceptible population. EV71 and CA16 were the predominant pathogens causing the epidemics of HFMD except in 2013, and CA6 was prevalent in the community cases in 2014. The major peak season of HFMD usually overlapped with the peak of EV71 circulation and the majority of severe HFMD cases were associated with EV71 infection.

摘要

目的

了解2010年至2014年上海市手足口病（HFMD）的流行病学特征以及引发HFMD流行的主要肠道病毒。

方法

利用2010年至2014年全市范围的监测数据，分析上海市HFMD疫情的流行病学特征。基于2010年上海市人口普查数据估算HFMD的年发病率。

结果

2010年至2014年，报告的HFMD病例数分别为41080例、37323例、51172例、42198例和65018例；重症病例（重症比例）分别为469例（1.14%）、456例（1.22%）、318例（0.62%）、104例（0.25%）和248例（0.38%）。根据2010年底上海市人口普查数据，上海市HFMD的发病率在整个人口中为0.16% - 0.28%。就特定人群中HFMD病例和重症病例的比例而言，男性占59.62% - 61.48%和62.26% - 73.08%，流动人口占51.86% - 62.40%和72.01% - 80.38%；1.0 - 1.9岁儿童占比最高，分别达22.70% - 27.00%和32.08% - 36.40%。HFMD在4月至7月达到高峰，与肠道病毒（EV）71的流行高峰同步，且在秋冬通常出现一个小高峰。所有危重症和死亡病例均由EV71引起。在重症HFMD病例中，EV71和柯萨奇病毒A（CA）16的检出率分别为73.08% - 88.09%和1.12% - 2.90%；在非重症住院患者中分别为19.75% - 48.74%和2.02% - 23.69%；在轻症社区病例中分别为16.78% - 40.08%和8.36% - 33.39%。2014年轻症社区病例中CA6和CA10的检出率分别为18.38%和1.43%。2013年社区病例中非EV71和非CA16肠道病毒占74.86%。