2009-2019年上海市徐汇区HFMD流行病学特征分析  

Analysis on epidemiological characteristics of HFMD in Xuhui District of Shanghai from 2009-2019

作　　者：段蓉[1] 周毅彬[2] 朱奕奕[3] 陈远方[1] 刘景壹[1] 周祺[1] 石敏[1] 汪澜[1] DUAN Rong;ZHOU Yi-bin;ZHU Yi-yi;CHEN Yuan-fang;LIU Jing-yi;ZHOU Qi;SHI Min;WANG Lan(Epidemic Prevention and Immunization Department,Xuhui District Center for Disease Control and Prevention,Shanghai,200237,China;Acute Infectious Disease Prevention and Control Department,Shanghai Municipal Center for Disease Control and Prevention,Shanghai,200336,China;Disinfection Vector Department,Shanghai Municipal Center for Disease Control and Prevention,Shanghai,200336,China)

机构地区：[1]上海市徐汇区疾病预防控制中心防疫计免科,上海200237 [2]上海市疾病预防控制中心消毒病媒科,上海200336 [3]上海市疾病预防控制中心急性传染病防治科,上海200336

出　　处：《职业与健康》2021年第14期1910-1915,共6页Occupation and Health

基　　金：上海市徐汇区医学科技项目(SHXH201738)。

摘　　要：目的了解上海市徐汇区手足口病(hand-foot-mouth disease,HFMD)病原学及其流行特征,为其防控提供参考依据。方法采用实时荧光定量聚合酶链式反应(polymerase chain reaction,PCR)对2009—2019年上海市徐汇区采集的上海市徐汇区HFMD病例标本进行肠道病毒检测,并对病原学检测数据进行整理分析。结果 2009—2019年上海市徐汇区共报告现住址在上海市徐汇区HFMD普通病例10 909例,年均报告发病率为84.79/10万(31.32/10万~135.53/10万),累计报告重症病例47例,重症率为0.43%。2009—2012年报告普通病例发病率呈现升高趋势,2013年始,发病率呈现隔年高发。HFMD发病呈现双峰模式,全年发病有2个高峰:4—7月(春夏高峰)占52.38%和9—11月(秋冬高峰)占26.17%,男性发病率(127.60/10万)高于女性发病率(83.58/10万)。实验室检测病例共1 239例,阳性标本1 029例(占83.05%)。其中,柯萨奇病毒A组6型(CA6)为29.78%、肠道病毒71型(EV71)为21.55%、柯萨奇病毒A组16型(CA16型)为21.23%和其他肠道病毒为10.09%、柯萨奇病毒A组10型(CA10)为0.32%、EV71/CA16混合感染0.08%。上海市徐汇区全年均有HFMD病例报告,发病高峰期为每年3—11月。每年HFMD病毒的型别特征各不相同。病毒核酸检测阳性病例以<18岁青少儿童为主(99.19%),男性病例阳性检出率(83.24%)略高于女性(82.75%),差异无统计学意义(χ^(2)=0.051,P>0.05)。47例重症患者标本中,重症病例EV71型阳性率为16.10%,CA16型为0.38%和其他类型EV为0.80%。结论 2009—2019年上海市徐汇区HFMD病原谱以CA6型为主,除了EV71和CA16型,还有其他新型肠道病毒,且近年占比呈上升趋势,应予以重视和加强监测。Objective To understand the etiology and epidemic characteristics of hand-foot-mouth disease(HFMD) in Xuhui District of Shanghai,provide reference basis for prevention and control. Methods Real time fluorescent quantitative polymerase chain reaction( PCR) was used to detect enterovirus in HFMD cases collected in Xuhui District of Shanghai from 2009-2019,and the pathogenic detection data were analyzed. Results Totally 10 909 common cases of HFMD,whose current address is in Xuhui District of Shanghai,were reported from 2009-2019,the average annual incidence rate was 84.79/lakh(31.32/lakh-135.53/lakh),and 47 severe cases were reported with the severe rate of 0.43%. The incidence rate of common cases showed an increasing trend from 2009-2012,and it showed a higher incidence rate every other year since 2013. The incidence rate of HFMD showed a bimodal pattern, that is there was two peaks in the year,the cases in April to June(spring and summer peak) accounted for52.38% and the cases in September to November(autumn and winter peak) accounted for 26.17%. The incidence rate of males(127.60/lakh) was higher than that in females(83.58/lakh). There were 1 239 cases detected by laboratory,and 1 029 cases were positive(83.05%). Among them,coxsackievirus group A type 6(CA6) accounted for 29.78%,enterovirus 71(EV71) accounted for 21.55%,coxsackievirus group A type 16(CA16) accounted for 21.23%,other enteroviruses accounted for 10.09%,coxsackievirus group A type 10(CA10) accounted for 0.32%,and EV71/CA16 mixed infection accounted for 0.08%. HFMD cases were reported throughout the year in Xuhui District of Shanghai,and the peak season appeared March to November every year. The type characteristics of virus varied from year to year. The positive cases of viral nucleic acid detection were mainly children under18 years old(99.19%),and the positive rate of male cases(83.24%) was slightly higher than that of female(82.75%),but the difference was not statistically significant ( χ^(2)= 0. 051, P > 0. 05 ). Among 47 severe cases,the pos

关 键 词：手足口病 其他肠道病毒 肠道病毒71型 柯萨奇病毒A组6型 柯萨奇病毒A组16型 柯萨奇病毒A组10型 

分 类 号：R181.3[医药卫生—流行病学]