Chongqing Municipal Center for Disease Control and Prevention, Chongqing, No. 8, Changjiang 2nd Road, Yuzhong District, Chongqing 400042, China.
Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, No. 27, Nanwei Road, Xicheng District, Beijing 100050, China.
Int J Environ Res Public Health. 2018 Feb 5;15(2):270. doi: 10.3390/ijerph15020270.
(1) : Even with licensed vaccine for enterovirus 71 (EV71) put into market in 2016 in China, hand, foot, and mouth disease (HFMD) is still a threat for children's health in Chongqing. We described the epidemiological characteristics and spatial-temporal patterns of HFMD in Chongqing from 2009 to 2016, in order to provide information and evidence for guiding public health response and intervention. (2) : We retrieved the HFMD surveillance data from January 2009 to December 2016 from "National Disease Reporting Information System", and then analyzed demographic and geographical information integrally. Descriptive analysis was conducted to evaluate the epidemic features of HFMD in Chongqing. The spatial-temporal methods were performed to explore the clusters at district/county level. (3) : A total of 276,207 HFMD cases were reported during the study period (total population incidence: 114.8 per 100,000 per year), including 641 severe cases (129 deaths). The annual incidence of HFMD sharply increased in even-numbered years, but remained stable or decreased in odd-numbered years. A semiannual seasonality was observed during April to July, and October to December in each year. The male-to-female ratios of the mild and severe cases were 1.4:1 and 1.5:1, with the median age of 2.3 years and 1.9 years, respectively. More than 90% of the cases were children equal to and less than 5 years old. High-incidence clustered regions included the main urban districts and northeast regions according to incidence rates comparison or space-time cluster analysis. A total of 19,482 specimen were collected from the reported cases and 13,277 (68.2%) were positive for enterovirus. EV71 was the major causative agent for severe cases, while other enteroviruses were the predominant serotype for mild cases. (4) The characteristics of HFMD in Chongqing exhibited a phenomenon of increasing incidence in two-year cycles and semiannual seasonality in time distribution. Children ≤5 years old, especially boys, were more affected by HFMD. EV71 was the major causative agent for severe cases. We suggest initiating mass EV71 vaccination campaigns among children aged 6 months to 5 years in Chongqing, especially in the main urban districts and northern regions, in order to reduce case fatality, and take integrated measurements for controlling and preventing HFMD attributed to other enteroviruses.
(1) : 尽管中国于 2016 年批准了肠道病毒 71 型（EV71）疫苗上市，但手足口病（HFMD）仍是重庆儿童健康的威胁。我们描述了 2009 年至 2016 年重庆 HFMD 的流行病学特征和时空模式，为指导公共卫生应对和干预提供信息和依据。(2) : 我们从“国家疾病报告信息系统”中检索了 2009 年 1 月至 2016 年 12 月的 HFMD 监测数据，并对人口统计学和地理信息进行了综合分析。描述性分析用于评估重庆 HFMD 的流行特征。采用时空方法探讨区级/县级的聚集情况。(3) : 在研究期间共报告了 276207 例 HFMD 病例（总人群发病率：每年每 10 万人 114.8 例），其中 641 例为重症病例（129 例死亡）。HFMD 的年发病率在偶数年份急剧上升，但在奇数年份保持稳定或下降。每年 4 月至 7 月和 10 月至 12 月观察到半年度季节性。轻症和重症病例的男女比例分别为 1.4:1 和 1.5:1，中位年龄分别为 2.3 岁和 1.9 岁。超过 90%的病例为 5 岁及以下儿童。根据发病率比较或时空聚类分析，高发病率聚集区域包括主城区和东北部地区。从报告病例中采集了 19482 份标本，其中 13277 份（68.2%）为肠道病毒阳性。EV71 是重症病例的主要病原体，而其他肠道病毒是轻症病例的主要血清型。(4) 重庆手足口病的特征表现为两年一周期的发病率增加和时间分布上的半年季节性。≤5 岁儿童，尤其是男孩，受手足口病影响更大。EV71 是重症病例的主要病原体。我们建议在重庆为 6 个月至 5 岁的儿童开展大规模 EV71 疫苗接种活动，特别是在主城区和北部地区，以降低病死率，并采取综合措施控制和预防其他肠道病毒引起的手足口病。
