2011－2020年上海松江区手足口病的流行病学特征和时空聚集

钱燕琴 马纪林

摘 要 目的：描述手足口病（Hand，foot and mouth disease，HFMD）在上海松江区各街道/镇层面的流行病学与时空之间的分布特征。方法：从国家疾病监测系统中收集2011-2020年HFMD监测报告的数据来分析统计HFMD流行病集群和时空分布。结果：2011-2020年上海松江区HFMD的年均发病率为211.13/10万，92.60%的HFMD病例发病年龄在0～6岁之间，患者中男性占60.08%。HFMD的季节性高峰期在5-10月。HFMD的发病在街道/镇之间的分布是不均匀的，10年间有5个街道/镇发病率高于全区平均水平。HFMD病例主要集中在城乡边缘地区与人口稠密地区。结论：每年5月至10月，上海松江区城乡边缘地区与人口稠密地区是HFMD的高发地区；学龄前儿童是重点防治人群。提示上海松江区HFMD的防控工作应重点关注这些高危时段、高发地区和重点人群，注意公共卫生资源的配置。

关键词 手足口病；发病率；时空聚集

中图分类号：R512.6 文献标志码：A 文章编号：1006-1533（2021）20-0046-04

Epidemiological characteristics and temporal and spatial aggregation of hand， foot and mouth disease in Songjiang， Shanghai from 2011 to 2020

QIAN Yanqin， MA Jilin（Prevention and Health Care Department of Sijing Community Health Service Center of Songjiang District， Shanghai 201601， China）

ABSTRACT Objective： To describe the distribution characteristics between epidemiology and time and space of hand， foot and mouth disease（HFMD） at the sub district/town levels in Songjiang District， Shanghai. Methods： HFMD surveillance and reporting data were collected from the national disease surveillance system for the period 2011-2020 to analyse statistical HFMD epidemic clusters and temporal and spatial distribution. Results： From 2011 to 2020， the average annual incidence of HFMD cases in Songjiang District was 211.13/100 000， 92.60% of HFMD cases occurred between 0 and 6 years old， and men accounted for 60.08%. The seasonal peak was between May and October. The incidence of HFMD was unevenly distributed among sub districts/towns， and the incidence rate of 5 sub districts/towns was higher than that of the whole district in 10 years. HFMD cases were mainly concentrated in the rural and urban fringe areas and in densely populated areas. Conclusion： The main locations of HFMD are the rural and urban fringe areas and the densely populated areas of Songjiang District， Shanghai between May and October； preschool children are the key population for prevention and treatment. It is suggested that the prevention and control of HFMD in Songjiang District of Shanghai should focus on these high-risk periods， high-risk areas and key groups， and pay attention to the allocation of public health resources.

KEY WORDS hand， foot and mouth disease； incidence； temporal and spatial aggregation

手足口病（hand，foot and mouth disease，HFMD）是一種由肠道病毒71型和柯萨奇病毒A16型引起的常见肠道传染病[1-2]。HFMD主要以发热、口腔溃疡、手脚和口腔疱疹的临床表现为特征，主要是通过接触患者的唾液、呼吸道飞沫、粪便、水泡液等的人与人之间直接传播以及通过被污染的物品间接传播。大多数有症状病例发生在0～5岁的儿童，但也可在较大年龄的儿童和成人中发病。大多数病例属于自限性的，但少数病例可能出现严重的并发症，包括神经系统症状，如脑炎、脑膜炎甚至死亡[3-4]。在过去的10年中，包括中国在内的东亚和东南亚地区出现了大量的HFMD暴发的报道[5-6]。2007年和2008年，山东和安徽省发生了大规模的HFMD暴发，导致了大量的聚集性病例和死亡[7-8]。卫生部于2008年5月2日将HFMD列为丙类法定传染病[9]。