2010—2020年上海市普陀区手足口病监测及重症危险因素分析

Epidemiological features of hand-foot-mouth disease and risk factors for severe cases in Shanghai Putuo district from 2010 to 2020

目的了解上海市普陀区2010—2020年手足口病(hand-foot-mouth disease,HFMD)流行特征及重症病例主要危险因素,为手足口病的防控工作提供科学依据。方法根据手足口病监测方案,收集上海市普陀区手足口病病例,并对其进行采样开展病原学检测,使用RT-PCR方法进行鉴定。对纳入的数据进行统计分析。结果根据2010—2020年上海市普陀区手足口病监测数据显示,年龄以14岁患儿居多,男性多于女性。流行时间分布呈现出双峰模式,以5—6月、9—10月发病率较高。非肠道病毒在2010—2020年间均展现其流行性,不同年份亦伴有其他病毒株流行;但自2018年起至2020年CA6型转为主要流行病毒株。关于重症手足口病风险因素分析显示,感染EV71型、男性、发病距离就诊时间越长发生重症手足口病的风险更高。结论加强手足口病的监测和管理,关注全球及区域内流行病株的变化趋势,重视本病高发季节对重点人群及家人进行疾病相关知识的普及。同时,应积极研发安全有效的多价疫苗。

Objective To investigate the epidemiological characteristics of hand-foot-mouth(HFMD)disease and the risk factors of severe cases in Putuo District,Shanghai from 2010 to 2020.Methods According to the monitoring scheme of hand-foot-mouth disease,the cases of HFMD in Putuo District,Shanghai were collected.The etiological tests were performed with RT-PCR method.Results According to the HFMD data monitored in Putuo District from 2010 to 2020,the age distribution of cases was mostly 14 years,with more males than females.The time of epidemic showed a bimodal distribution,with a higher incidence rate from May to June and September to October.The main epidemic strains were non-enteroviruses in most of years during 2010 to 2020,and other strains were also concomitant endemic in different years;however,CA6 became the main epidemic strain from 2018 to 2020.The contracting EV 71 type,male gender,and longer onset time were risk factors for severe cases of HFMD.Conclusion Strengthening the monitoring and management,popularizing disease-related knowledge to target populations and developing safe and effective multivalent vaccines are important to prevent and control the hand-foot-mouth disease.