关键词: 手足口病, 流行特征, 病原学特征, 重症病例, 昆明市

Abstract:

Objective To analyze the epidemiological and etiological characteristics of hand, foot and mouth disease (HFMD) as well as the influencing factors for severe HFMD cases in Kunming area for scientific evidences in formulating surveillance and prevention strategies. Methods The case data of HFMD reported from Kunming area between January 1, 2010 and December 31, 2024 were initially retrieved via the Chinese Disease Prevention and Control Information System, and then analyzed regarding the temporal, geographic and demographic distribution, etiological characteristics, and the influencing factors associated with severe HFMD. Results In total, 247 275 cases of HFMD were reported in Kunming area from 2010 to 2024, with an average annual incidence rate of 231.64/100 000. OF the cases, 5 718 were severe, and 30 deaths were reported. The average annual severe rate and mortality rate were 5.36/100 000 and 0.03/100 000, respectively. The reported incidence rate, severe rate, and mortality rate showed a trend of decline (Z=-113.14, -52.95, -7.29, all P < 0.05). The incidence presented with bimodal distribution, and peaked from April to July (138 233 cases, 55.90%) and October to December (59 306 cases, 23.98%). The top three counties (cities, districts) with the highest incidence were Songming County (358.67/100 000), Guandu District (316.82/100 000), and Shilin Yi Autonomous County (300.93/100 000). The incidence was dominated by children aged 0 to 5 years (227 675 cases, 92.07%), and children living at home (132 412 cases, 53.55%). Among the laboratory-confirmed cases, 10 064 cases (32.07%) were EV-A71 type, 10 519 cases (33.52%) were CVA16 type, and 10 799 cases (34.41%) were other enteroviruses. The dominant serotypes of HFMD cases reported in Kunming area between 2010 and 2015 were EV-A71 (7 546 cases, 46.11%) and CVA16 (7 155 cases, 43.73%). In 2016, the proportion of other enteroviruses was basically equal to that of EV-A71 type. From 2017 to 2024, other enteroviruses became the dominant serotype of HFMD in Kunming City (7 272 cases, 69.86%). Multivariate logistic regression analysis showed that children under 3 years old, male cases, children living at home, and population living in suburban area were risk factors for developing into severe HFMD, yet the treatment within 3 days after the onset was a protective factor. Conclusion Overall, the incidence of HFMD in Kunming area tends to decline over time, and dominant enterovirus serotypes causing HFMD in current stage are other enteroviruses. We suggest that timely medical treatment of high-risk groups is the key to prevent severe diseases.

Key words: Hand, foot and mouth disease, Epidemiological characteristics, Pathogen property, Severe cases, Kunming City