摘要
目的 了解2010至2014年上海地区手足口病患儿的流行病学特征以及引起手足口病流行的主要肠道病毒.方法 描述性分析2010至2014年上海地区手足口病患儿的人口统计学资料、季节分布以及社区和住院病例的肠道病毒分型结果.结果 2010至2014年上海地区报告的手足口病病例数分别为41 080、37 323、51 172、42 198和65 018,重症病例数（重症比率）分别为469（1.14％）、456（1.22％）、318（0.62％）、104（0.25％）和248（0.38％）.以2010年底上海市人口普查数据为基准,上海地区手足口病总体人群发病率为0.16％～0.28％.手足口病和重症手足口病病例数在不同人群的构成比：男性分别为59.62％～61.48％和62.26％～73.08％,外来人群分别为51.86％～62.40％和72.01％ ～ 80.38％.重症病例中1.0～1.9岁儿童所占比例最高,为32.08％～36.40％;其次是2.0～2.9岁儿童（17.31％～26.21％）.上海地区手足口病高峰季节发生在4至7月份,同期肠道病毒71型（EV71）优势流行,秋冬季节出现小的流行高峰.所有危重症和死亡手足口病病例均系EV71感染所致;重症患儿的EV71和柯萨奇病毒A组16型（CA16）检出率分别为73.08％ ～88.09％和1.12％ ～2.90％;无并发症住院患儿的EV71和CA16检出率分别为19.75％ ～48.75％和2.02％～23.69％;社区轻症患儿的EV71和CA16检出率分别为16.78％～40.08％和8.36％ ～33.39％,2014年社区轻症患儿的CA6和CA10检出率分别为18.39％和1.43％.结论 2010至2014年间手足口病在上海地区连年暴发流行.5岁以下儿童、外来流动人群和男性是主要易感人群.除2013年外,引起本市手足口病流行主要的病原体是EV71和CA16,2014年CA6在社区儿童中优势流行.手足口病大流行高峰通常与EV71流行高峰重叠,重症病例绝大部分系EV71感染所致.
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 citywide 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.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2015年第9期676-683,共8页
Chinese Journal of Pediatrics
关键词
手足口病
儿童
肠道病毒属
柯萨奇病毒感染
Hand,foot and mouth disease
Child
Enterovirus
Coxsackievirus infections
