Wu Baiqun, Zhang Xiangnan, Fu Minhui, Ji Xiaoming
The Jiangning District Center for Disease Control and Prevention, Nanjing, China.
Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, China.
BMC Infect Dis. 2025 Jul 2;25(1):886. doi: 10.1186/s12879-025-11281-y.
This study aimed to analyse the epidemiological characteristics of hand, foot, and mouth disease (HFMD) among children under age 10 in Jiangning District, Jiangsu Province, from 2009 to 2023, explore its changing trends, and provide a scientific basis for optimizing public health prevention and control strategies.
HFMD case data were obtained from the "Notifiable Infectious Disease Reporting Information Management System". Descriptive statistical analysis was used to assess HFMD incidence, joinpoint regression analysis was applied to analyse long-term trends, and wavelet analysis was used to explore seasonality and periodicity.
A total of 50,645 HFMD cases in children under 10 years of age were reported during the study period, with an average annual incidence rate of 3,136.01 per 100,000 people. The annual incidence rate fluctuated between 544.39 per 100,000 (in 2022) and 6,260.63 per 100,000 (in 2018), showing an initial steady increase, followed by a sharp decline and a rapid rebound. HFMD showed a pronounced incidence peak during summer and autumn, with periodic fluctuations at intervals of 6 months, 12 months, and 24 months. Boys had a higher incidence rate, with an average annual rate of 3588.07 per 100,000, compared with 2646.00 per 100,000 in girls. Children aged 1 and 3 years had the highest incidence rates. The dominant serotypes shifted, with an overall decline in the proportions of EV-A71 and CVA16, whereas CVA6 emerged as the predominant circulating serotype. Moreover, the proportion of severe cases has continued to decrease.
The incidence of HFMD among children under age 10 in Jiangning District remains high, and the predominant serotypes have changed in recent years. The decline in incidence during the COVID-19 pandemic and its subsequent recovery may be linked to non-pharmacological interventions and the "immune debt" phenomenon, a relationship that warrants further validation. The EV-A71 vaccine and improved public health interventions have contributed to a steady decline in the severity rate. Strengthening surveillance, developing vaccines targeting predominant serotypes, and optimizing prevention and control strategies are essential for the precise prevention and control of HFMD in children.
本研究旨在分析2009年至2023年江苏省江宁区10岁以下儿童手足口病（HFMD）的流行病学特征，探讨其变化趋势，为优化公共卫生防控策略提供科学依据。
手足口病病例数据来自“法定传染病报告信息管理系统”。采用描述性统计分析评估手足口病发病率，应用Joinpoint回归分析分析长期趋势，采用小波分析探讨季节性和周期性。
研究期间共报告10岁以下儿童手足口病病例50645例，年均发病率为每10万人3136.01例。年发病率在每10万人544.39例（2022年）至每10万人6260.63例（2018年）之间波动，呈现先稳步上升，后急剧下降，又快速反弹的趋势。手足口病在夏秋季节发病率明显偏高，具有6个月、12个月和24个月的周期性波动。男孩发病率较高，年均发病率为每10万人3588.07例，女孩为每10万人2646.00例。1岁和3岁儿童发病率最高。优势血清型发生变化，肠道病毒A71型（EV-A71）和柯萨奇病毒A16型（CVA16）的比例总体下降，而柯萨奇病毒A6型（CVA6）成为主要流行血清型。此外，重症病例比例持续下降。
江宁区10岁以下儿童手足口病发病率仍处于高位，近年来优势血清型发生了变化。新冠疫情期间发病率下降及其后回升可能与非药物干预措施和“免疫债”现象有关，这一关系有待进一步验证。EV-A71疫苗和公共卫生干预措施的改善促使重症率稳步下降。加强监测、研发针对优势血清型的疫苗以及优化防控策略对于精准防控儿童手足口病至关重要。
