新型冠状病毒感染“乙类乙管”后我国手足口病流行特征与趋势分析

Analysis of the epidemic trend of hand,foot and mouth disease in China after COVID-19 as a category B disease

目的了解新型冠状病毒感染“乙类乙管”后我国手足口病的流行特征和变化趋势,为科学应对和防控手足口病提供参考。方法采用描述流行病学方法对全国2023年1—6月手足口病病例报告情况、肠道病毒血清型构成情况等进行分析,并与2017—2019年和2020—2022年的同期平均水平进行对比;采用移动流行区间法(moving epidemic method,MEM)评估2023年1—6月我国手足口病的流行强度。结果2023年1—6月,全国报告手足口病病例557940例,报告发病率为39.68/10万,低于2017—2019年同期平均报告发病率(64.97/10万),高于2020—2022年同期平均报告发病率(26.37/10万)。从发病趋势来看,2023年手足口病发病高峰期较往年推迟,第20周报告病例数快速上升,第26周达到极高流行水平。从病原构成来看,2023年1—6月全国报告的实验室确诊病例中,肠道病毒A组71型(enterovirus A71,EV-A71)、柯萨奇病毒A组16型(coxasckievirus A16,CV-A16)和其他肠道病毒感染病例构成比分别为14.31%(4694/32804)、12.18%(3995/32804)和73.51%(24115/32804);与2017—2019年和2020—2022年同期平均水平相比,EV-A71和CV-A16构成比均下降,而其他肠道病毒构成比均上升。MEM评估结果显示,2023年上半年南方手足口病总体流行强度高于北方,其中广东处于极高流行水平,江西和湖南处于中流行水平,贵州、四川、湖北、重庆和浙江处于低流行水平。结论2023年,我国手足口病春夏季发病高峰后移,峰值明显高于新型冠状病毒感染疫情前同期平均水平,南方省份流行高峰早于北方省份。建议各省密切关注本省手足口病流行状况动态变化,做好疫情分析和风险评估工作。

Objective To understand the epidemiological characteristics and changes of hand,foot and mouth disease(HFMD)in China after COVID-19 ranked as category B disease for evidence in scientific prevention and control of HFMD.Methods Descriptive epidemiological analysis was conducted to address the incidence and the composition of each enterovirus serotype of HFMD in China from January to June,2023,and the results were compared with the corresponding findings in 2017-2019 and 2020-2022.Moving epidemic method(MEM)was used to estimate the epidemic intensity of HFMD reported from January to June,2023 in China.Results From January to June,2023,a total of 557940 cases of HFMD were reported.The reported incidence was 39.68/100000,which was lower than the average incidence reported in the corresponding period of 2017-2019(64.97/100000),yet higher than the average incidence reported in the same period of 2020-2022(26.37/100000).The peak of the HFMD incidence in 2023 was delayed compared to the trends in previous years.The number of cases was rapidly increased after the 20th week,and reached a very high epidemic level by the 26th week.From January to June,2023,the proportion of enterovirus A71(EV-A71),coxasckievirus A16(CV-A16)and other enterovirus in laboratory-diagnosed cases was 14.31%(4694/32804),12.18%(3995/32804)and 73.51%(24115/32804),respectively.Compared with the average level of the same period in 2017-2019 and 2020-2022,the proportion of EV-A71 and CV-A16 decreased,while the proportion of other enterovirus increased.MEM evaluation results showed that the prevalence intensity of HFMD was higher in the south China than in the north,among which Guangdong remained at a very high epidemic level,whereas Jiangxi and Hunan were at medium epidemic level.Guizhou,Sichuan,Hubei,Chongqing and Zhejiang were at lower epidemic level.Conclusion In 2023,the incidence peak of HFMD in spring and summer in China moved backward,and the peak of this disease in the country exceeds the pre-pandemic level,and the epidemic peak in southern provinces was earlier than that in northern provinces,for which we suggest that all provinces should closely monitor the dynamic changes of the local epidemic by conducting epidemic analysis and risk assessment.