我国手足口病分子流行病学及防控管理措施探讨

Molecular epidemiology of HFMD in China's Mainland and discussion on prevention and control measures

目的 分析汇总公开发表的＂2013—2017年＂间我国手足口病流行病学及病原学相关数据,浅析手足口病分子流行病学特征,为完善我国手足口病防控管理措施提供科学依据.方法 检索中国知网、万方数据库、维普网、PubMed数据库,以及中华人民共和国国家卫生和计划生育委员会、世界卫生组织网站发布的2013—2017年份我国大陆地区手足口病疫情的相关监测数据,采用描述性统计学分析方法对数据进行综合整理分析.结果 2013—2017年我国手足口病发病率分别为134.37/10万、203.16/10万、145.30/10万、176.62/10万、140.46/10万;2013—2017年上半年间导致手足口病的病原主要有肠道病毒71型（enterovirus 71,EV71）、柯萨奇病毒A16型（coxsackievirus A16,CA16）、CA6、CA10等,CA6已成为我国大部分地区的主要流行株.重症病例中EV71仍为主要的病原,CA6、CA10、CA16也是重要致病原;而不同年份、不同地区手足口病的优势株有所不同.结论 2016年中EV71疫苗正式上市,但目前我国手足口病尚未得到完全控制,仍需加强防控管理,并加强肠道病毒分型监测,以正确评估我国手足口病流行趋势,加快多价疫苗研发进程,以完善我国对手足口病的防控管理措施.

Objective To summarize the epidemiological data of hand, foot and mouth disease （HFMD） in China from 2013 to 2017 and to analyze its molecular epidemiological characteristics in order to provide scientific basis for improving prevention and control measures. Methods China National Knowledge In-frastructure,Wanfang Database of China,Chinese VIP Journal Net and Pubmed were used to search epidemio-logical data of HFMD published in recent years. National notification data and surveillance data of HFMD in ma-inland China were obtained from the National Health and Family Planning Commission of China and the World Health Organization. Basic statistic tools were used for data analysis. Results From 2013 to 2016, the inci-dence rates of HFMD were 134. 37/100 000, 203. 16/100 000, 145. 30/100 000, 176. 62/100 000 and 140.46/100 000,respectively. Enterovirus 71（EV71）,coxsackievirus A16（CA16）,CA6 and CA10 were the predominant pathogens causing HFMD in the first half of 2013-2017. CA6 was the main epidemic strain in most areas of China. EV71 remained the predominant pathogen causing severe HFMD, but CA6, CA16 and CA10 were also critical pathogens of concern. The predominant strains of enteroviruses varied with year and region. Conclusion Although the EV71 vaccine has been approved since 2016, HFMD has not been controlled com-pletely in China. It is badly in need of more comprehensive surveillance of other types of enteroviruses and HFMD polyvaccine to improve the prevention and control of HFMD.