2016年-2020年上海市松江区手足口病聚集性疫情流行病学及病原学特征分析

Analysis of Epidemiological and Etiological Characteristics of the Clustered Epidemic Situation of Hand,Foot and Mouth Disease in Songjiang District,Shanghai from 2016 to 2020

目的分析上海市松江区手足口病聚集性疫情流行病学和病原学特征,为做好手足口病防控工作提供科学依据。方法选取松江区2016年1月1日-2020年12月31日手足口病聚集性疫情资料进行流行病学分析,并采集手足口病聚集性疫情中病例标本,进行病原学检测,分析病原学特征。结果上海市松江区2016年-2020年共报告手足口病聚集性疫情678起,呈逐年下降趋势,占同期总报告病例的16.05%;除2020年外,其余4年疫情报告高峰为5月-7月和10月-12月;手足口聚集性疫情主要发生在托幼机构(69.17%),其次在家庭(18.44%)和学校(12.39%);托幼儿童是高发人群;方松、九亭和泗泾属于聚集性疫情高发地区;病原呈多种肠道病毒基因型并存,且CV-A6和CV-A16交替作为优势毒株;首发病例发病-疫情报告时间间隔与疫情持续时间、发病人数呈正相关(r=0.514、0.153,P<0.05)。结论托幼机构是松江区手足口病聚集性疫情主要场所,卫生相关部门应在高峰期来临前强化私立幼儿园督导,针对重点区域和托幼儿童做好手足口病监控,及时发现、报告与正确处置是防控手足口病聚集性疫情的关键。

Objective To analyze the epidemiological and etiological characteristics of the hand-foot-mouth disease cluster epidemic in Songjiang District,Shanghai,and provide a scientific basis for the prevention and control of hand-foot-mouth disease.Methods The collected data of hand-foot-mouth disease in Songjiang District from January 1,2016 to December 31,2020 were selected for epidemiological analysis,and specimens of cases in the hand-foot-mouth disease cluster were collected for pathogen detection and pathogen analysis feature.Results A total of 678 cases of hand-foot-mouth disease clusters were reported in Songjiang District,Shanghai from 2016 to 2020,showing a downward trend year by year,accounting for 16.05%of the total reported cases during the same period;Except for 2020,the peak of the epidemic report in the remaining four years was May-July and October-December;the hand-foot-mouth cluster epidemic mainly occurred in kindergartens(69.17%),followed by families(18.44%)and schools(12.39%);Children in kindergartens were a high-risk population;Fangsong,Jiuting and Sijing are areas with high incidence of cluster epidemics;the pathogens coexist with multiple enterovirus genotypes,and CV-A6 and CV-A16 alternate as the dominant strain;The first-case onset-epidemic report interval was positively correlated with the duration of the epidemic and the number of cases(r=0.514,0.153,P<0.05).Conclusion The kindergartens are the main places where the hand,foot and mouth disease is clustered in Songjiang District.The relevant health departments should strengthen the supervision of private kindergartens before the peak.Monitoring of hand,foot and mouth disease in key areas and kindergarten children,timely detection,reporting and correct disposal are the key to preventing and controlling a cluster of hand,foot and mouth disease.