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2020—2024年安庆市手足口病流行特征及时空聚集性分析
The epidemiological characteristics and spatiotemporal clustering of hand, foot and mouth disease in Anqing from 2020 to 2024
目的 分析2020—2024年安庆市手足口病（hand, foot and mouth disease, HFMD）流行特征及时空聚集性，为精准防控提供科学依据。方法 通过中国疾病预防控制信息系统获取HFMD病例资料，对其三间分布及病原学特征进行描述性分析，使用GeoDa 1.22.0.4软件分析HFMD病例的空间自相关性，使用SaTScan 10.1.2软件分析时空聚集性。结果 2020—2024年累计报告病例12 750例，年均发病率61.50/10万，2022年达最高（93.98/10万），平均发病率位居前3位的县（市、区）依次是太湖县（131.28/10万）、迎江区（101.90/10万）和宜秀区（98.32/10万）。除2020年外，发病高峰总体是在4—7月；除2021年外，其余年份为单峰分布。1~4岁儿童发病占比最高（占76.27%），15岁及以上人群发病构成稳定；0岁、1岁、3岁组发病构成比变化趋势与5、6~9岁组变化相反。2021—2024年，CVA6和CVA16两种型别交替流行，2023年CVA6构成比达到87.43%。空间自相关显示各年全局Moran’s Ⅰ均显著正相关（Moran’s Ⅰ：0.179~0.388，P<0.05），高-高聚集区从农村（2020—2022年太湖县、岳西县）转移至市区（2023年迎江区）；逐年时空扫描识别一类聚集区5个，总体时空扫描识别到1个一类聚集区和5个二类聚集区。结论 2020—2024年安庆市HFMD发病存在明显的时空聚集性，4—7月为发病高峰，1~4岁散居儿童为重点人群，太湖县、岳西县、怀宁县以及迎江区主城区及周边人口密集乡镇（街道）为重点防控区域，应在流行期来临前和流行期进一步加强重点人群和地区的防控工作。
Objective To analyze the epidemiological characteristics and spatiotemporal clustering of hand, foot and mouth disease (HFMD) in Anqing from 2020 to 2024, and to provide scientific basis for precise prevention and control. Methods The case data of HFMD cases were obtained from the China Disease Prevention and Control Information System. Descriptive analysis was used to analyze the temporal, spatial, and population distributions, as well as the etiological characteristics. GeoDa 1.22.0.4 software was used for spatial autocorrelation analysis, SaTScan 10.1.2 software was used to conduct spatiotemporal scan analysis. Results From 2020 to 2024, a total of 12 750 HFMD cases were reported, with an average annual incidence rate of 61.50/100 000. The highest incidence rate (93.98/100 000) was recorded in 2022. The top three areas with the highest average incidence rates were Taihu County (131.28/100 000), Yingjiang District (101.90/100 000), and Yixiu District (98.32/100 000). Except for 2020, the overall peak incidence generally occurred from April to July. Except for 2021, the annual incidence distribution showed a single peak in the other years. Children aged 1-4 years had the highest proportion of cases (76.27%). The proportion of incidence among individuals aged 15 years and above was stable. The trends of the incidence proportions of 0, 1, and 3-year-old groups were opposite to those of the 5 and 6-9-year-old groups. From 2021 to 2024, CVA6 and CVA16 serotypes alternated as the predominant strains, and the proportion of CVA6 reached 87.43% in 2023. Spatial autocorrelation analysis showed that the global Moran’s Ⅰ in each year was significantly positively correlated (Moran’s Ⅰ: 0.179-0.388, P<0.05), and the high-high clustering areas shifted from rural areas (Taihu County and Yuexi County from 2020 to 2022) to the urban areas (Yingjiang District in 2023). Five first-class clustering areas were identified through annual spatiotemporal scanning, and a total of 1 first-class clustering area and 5 second-class clustering areas were identified through overall spatiotemporal scanning. Conclusion HFMD incidence in Anqing from 2020 to 2024 exhibited obvious spatiotemporal clustering. The peak incidence period is from April to July. Scattered children aged 1-4 years are the key population. Taihu County, Yuexi County, Huaining County, as well as the main urban area of Yingjiang District and its surrounding densely populated towns (streets) are the key prevention and control areas. Prevention and control work for key populations and areas should be further strengthened before and during the epidemic period.
手足口病 / 流行特征 / CVA6 / 空间自相关 / 时空聚集性
Hand, foot and mouth disease / Epidemiological characteristics / CVA6 / Spatial Autocorrelation / Spatiotemporal clustering
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Hand, foot, and mouth disease (HFMD) is a public health issue in Hubei and studies of- spatiotemporal clustering at a fine scale are limited. The purpose of this research was to analyze the epidemiological characteristics, temporal variation characteristics, and spatiotemporal clustering of HFMD cases at the town level from 2009 to 2019 to improve public health outcomes.
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Hand, foot, and mouth disease (HFMD) is a highly prevalent and contagious disease, particularly in children under five years old. Its transmission route resembles that of COVID-19. During the COVID-19 pandemic, non-pharmaceutical interventions (NPIs) were implemented to curb viral spread, which may have concurrently reduced HFMD incidence.Utilizing HFMD surveillance data from the Anhui Provincial Center for Disease Control and Prevention (2015-2020) and varying levels of COVID-19 emergency measures, a Bayesian structural time series model predicted the counterfactual HFMD incidence and quantified the causal relationships with NPIs.During the implementation of NPIs, the 915 cases observed between weeks 4 and 20 of 2020 reflected a 94.9% reduction from the expected cases number (915 vs. 17,790), avoiding approximately 16,875 cases. The relative reduction of male cases (95.2%) was similar to that of female cases (94.3%). Different age groups the number of cases decline roughly similar were 93.1%, 95.3%, 97.8%, 94.9%.During the COVID-19 pandemic, NPIs implemented in response to COVID-19 effectively reduced HFMD incidence. NPIs should be promoted for future control of enteric infectious diseases such as HFMD.© 2024. The Author(s).
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Hand-foot-and-mouth disease (HFMD) is a viral illness commonly seen in young children under 5 years of age, characterized by typical manifestations such as oral herpes and rashes on the hands and feet. These symptoms typically resolve spontaneously within a few days without complications. Over the past two decades, our understanding of HFMD has greatly improved and it has received significant attention. A variety of research studies, including epidemiological, animal, and in vitro studies, suggest that the disease may be associated with potentially fatal neurological complications. These findings reveal clinical, epidemiological, pathological, and etiological characteristics that are quite different from initial understandings of the illness. It is important to note that HFMD has been linked to severe cardiopulmonary complications, as well as severe neurological sequelae that can be observed during follow-up. At present, there is no specific pharmaceutical intervention for HFMD. An inactivated Enterovirus A71 (EV-A71) vaccine that has been approved by the China Food and Drug Administration (CFDA) has been shown to provide a high level of protection against EV-A71-related HFMD. However, the simultaneous circulation of multiple pathogens and the evolution of the molecular epidemiology of infectious agents make interventions based solely on a single agent comparatively inadequate. Enteroviruses are highly contagious and have a predilection for the nervous system, particularly in child populations, which contributes to the ongoing outbreak. Given the substantial impact of HFMD around the world, this Review synthesizes the current knowledge of the virology, epidemiology, pathogenesis, therapy, sequelae, and vaccine development of HFMD to improve clinical practices and public health efforts.© 2023. The Author(s).
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梁东旭, 康强, 曾毅, 等. 基于分布滞后非线性模型探讨南宁市手足口病的发病与气象因素的关联[J]. 中华疾病控制杂志, 2023, 27(11):1254-1261.
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