2008—2022年昆山市手足口病流行特征及EV71疫苗接种效果分析

Epidemic characteristics of hand,foot and mouth disease and the effect of EV71 vaccination in Kunshan City,2008-2022

目的掌握昆山市手足口病自纳入法定管理以来的发病情况及疫苗接种效果,为制定有效地防控策略提供依据。方法用描述性流行病学方法对2008—2022年昆山市手足口病发病、病原学监测和疫苗接种等资料进行分析。结果2008—2022年昆山市累计报告手足口病25759例,年平均报告发病率为70.80/10万,低于全国同期水平;重症病例占比明显下降;隔年高发;一年中有两个发病高峰,分别是5—7月和9—11月;男性发病率高于女性;发病年龄集中在5岁以下,3岁以下最高;乡镇发病率高于城区;2014—2016年以EVG型和CoxA16型为主,2017—2022年则以CoxA6型为主;EV71疫苗推广后手足口病重症病例的占比低于推广前(P<0.001)。结论2008—2022年昆山市手足口病呈高发态势,EV71疫苗防重症的效果较好,需积极研发多价疫苗并提高疫苗接种率,强化健康宣教和干预,采取综合措施减少手足口病的发病。

Objective To understand the incidence situation and vaccination effect of hand,foot and mouth disease(HFMD)since it was brought into legal management,and to provide a basis for formulating effective prevention and control strategies.Methods Descriptive epidemiological methods were used to analyze the data regarding HFMD incidence,etiology monitoring and vaccination in Kunshan City from 2008 to 2022.Results A total of 25,759 HFMD cases were cumulatively reported in Kunshan City from 2008 to 2022,and the average annual reported incidence rate was 70.80/100,000,which was lower than the national level of the same period.The proportion of severe cases decreased significantly.The incidence peak occurred every other year.Two incidence peaks were observed each year,one in May-July,and another in September-November.The incidence rate was higher in males than in females.The age-at-onset in HFMD was concentrated in children under 5 years old,and most of the cases were children below the age of 3 years.The incidence rate was higher in townships than in urban areas.The main pathogens were EVG and CoxA16 in 2014-2016,and CoxA6 was predominant in 2017-2022.After the wide use of EV71 vaccine,the proportion of severe cases was lower than that before the promotion(P<0.001).Conclusion HFMD in Kunshan City during 2008-2022 showed a trend of high incidence,and EV71 vaccine had better effect on preventing severe HFMD.It is necessary to actively develop a multivalent vaccine and improve the vaccination rate,strengthen health education and intervention,and take comprehensive measures to reduce the incidence of HFMD.