Department of Infectious Diseases, 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.
Emerg Microbes Infect. 2018 Mar 21;7(1):37. doi: 10.1038/s41426-018-0035-z.
Hand, foot, and mouth disease (HFMD) is mainly epidemic in China and Southeast Asian countries. A novel enterovirus 71 vaccine has been available in China for preventing severe HFMD since 2016. Knowledge of the dynamic epidemiology of HFMD in different regions is necessary for appropriate intervention strategies. This study focused on the citywide surveillance data on the epidemiology and etiology of HFMD in Shanghai during 2014-2016. In these 3 years, the total numbers of reported HFMD cases were 65,018, 39,702, and 57,548, respectively; the numbers of severe cases (case-severity ratios) were 248 (0.38%), 35 (0.09%), and 59 (0.10%), respectively. Children <6 years old accounted for 86.65% to 89.34% of HFMD cases and 91.53 to 97.14% of severe cases. EV-A71 caused all three fatal cases. In severe cases, the detection rate of EV-A71 was 77.82% in 2014, 100% in 2015 and 98.31% in 2016. In uncomplicated inpatient cases, the detection rates of EV-A71, CV-A16, CV-A6, and CV-A10 were, respectively, 43.40, 22.10, 30.73, and 1.89% in 2014; 28.52, 6.46, 53.61, and 7.98% in 2015; and 31.79, 14.15, 44.55, and 4.64% in 2016. In mild community cases, the detection rates of EV-A71, CV-A16, CV-A6, and CV-A10 were, respectively, 25.78, 41.64, 22.93, and 1.78% in 2014; 17.41, 21.23, 50.99, and 3.15% in 2015; and 18.92, 27.84, 45.11, and 1.64% in 2016. Among the cluster outbreaks, the most common pathogen was CV-A16 in 2014 (50.69%) and 2015 (38.10%) and CV-A6 in 2016 (36.30%). These findings show that HFMD outbreaks remained at a high level in Shanghai during 2014-2016. CV-A6 was emerging as the most common pathogen causing HFMD.
手足口病（HFMD）主要流行于中国和东南亚国家。自 2016 年以来，中国已经有一种新型肠道病毒 71 型疫苗可用于预防重症 HFMD。了解不同地区 HFMD 的动态流行病学情况对于制定适当的干预策略是必要的。本研究关注 2014-2016 年期间上海市全市范围内 HFMD 的流行病学和病因学监测数据。在这 3 年中，报告的 HFMD 病例总数分别为 65018、39702 和 57548 例；重症病例数（病例严重程度比）分别为 248（0.38%）、35（0.09%）和 59（0.10%）。<6 岁的儿童占 HFMD 病例的 86.65%至 89.34%，占重症病例的 91.53%至 97.14%。EV-A71 引起了所有 3 例死亡病例。在重症病例中，2014 年 EV-A71 的检出率为 77.82%，2015 年为 100%，2016 年为 98.31%。在无并发症住院病例中，2014 年 EV-A71、CV-A16、CV-A6 和 CV-A10 的检出率分别为 43.40%、22.10%、30.73%和 1.89%；2015 年为 28.52%、6.46%、53.61%和 7.98%；2016 年为 31.79%、14.15%、44.55%和 4.64%。在轻症社区病例中，2014 年 EV-A71、CV-A16、CV-A6 和 CV-A10 的检出率分别为 25.78%、41.64%、22.93%和 1.78%；2015 年为 17.41%、21.23%、50.99%和 3.15%；2016 年为 18.92%、27.84%、45.11%和 1.64%。在聚集性疫情中，2014 年和 2015 年最常见的病原体是 CV-A16（分别为 50.69%和 38.10%），2016 年则是 CV-A6（36.30%）。这些发现表明，2014-2016 年期间上海市 HFMD 疫情仍处于较高水平。CV-A6 是导致 HFMD 的最常见病原体。
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