2017—2022年上海市浦东新区手足口病聚集性疫情特征分析

Analysis of epidemiological characteristics of the clustered cases of hand,foot and mouth disease in Pudong New Area,Shanghai,2017‒2022

【目的】分析2017—2022年上海市浦东新区手足口病聚集性疫情流行病学和病原体特征,为浦东新区手足口病疫情防控提供科学依据。【方法】通过浦东新区手足口病聚集性疫情数据库获取2017—2022年手足口病聚集性疫情相关数据,描述性分析疫情波及范围、季节性特征、场所分布以及病原学构成。【结果】2017—2022年浦东新区共报告手足口病聚集性事件2547起,涉及病例8884例,平均每起事件发病数为3.49例,其中2~4例病例数占比最高(78.52%)。2017—2019年及2021年手足口病聚集性疫情报告高峰为夏峰5—7月和秋峰9—11月,2020年及2022年受新型冠状病毒感染疫情影响季节性不明显。手足口聚集性疫情主要发生在幼托机构(44.64%),其次为家庭/居委(44.21%),学校占比较少(12.39%)。病原呈多种肠道病毒基因型并存,阳性检出率为60.46%,且CoxA6为优势毒株。【结论】浦东新区手足口病聚集性疫情呈现波动趋势,不同年份事件数差别较大,流行季节为夏季和秋季,优势毒株为CoxA6。新型冠状病毒感染防控期间的各项措施显著降低了手足口病聚集性疫情的发生,未来仍须加强监测,关注重点机构大规模聚集性疫情的发生。

[Objective]To analyze the epidemiological characteristics and etiology of clustered outbreaks of hand,foot,and mouth disease(HFMD)in Pudong New Area,Shanghai from 2017 to 2022,and to provide a scientific basis for the prevention and control of HFMD in the area.[Methods]The data related to HFMD clustered outbreaks from 2017 to 2022 were obtained from the Pudong New Area HFMD outbreak database.Descriptive analysis was conducted to explore the outbreak scope,seasonal characteristics,distribution of occurrence settings,and etiological composition.[Results]From 2017 to 2022,Pudong New Area reported a total of 2547 HFMD clusters,involving 8884 cases,with an average of 3.49 cases per event.The majority of events(78.52%)had between 2 and 4 cases.The peak reporting periods for clustered HFMD from 2017 to 2019 and in 2021 were during the summer(May‒July)and autumn(September‒November).The seasonal pattern was less distinct in 2020 and 2022,likely due to the impact of the COVID-19 pandemic.The majority of clustered outbreaks occurred in childcare facilities(44.64%),followed by households/neighborhood committees(44.21%),with schools accounting for a smaller proportion(12.39%).The etiology revealed the coexistence of multiple enterovirus genotypes,with a positive detection rate of 60.46%,and CoxA6 being the dominant strain.[Conclusion]HFMD clustered outbreaks in Pudong New Area show fluctuating trends,with significant yearly differences in the number of incidents.The predominant seasons for outbreaks are summer and autumn,with CoxA6 identified as the dominant strain.The implementation of prevention and control measures for COVID-19 significantly reduced the occurrence of HFMD outbreaks.Continuous monitoring and focus on large-scale clustered outbreaks in key institutions are essential for the future.