热带病与寄生虫学

热带病与寄生虫学 ›› 2025, Vol. 23 ›› Issue (2): 65-69,97.doi: 10.20199/j.issn.1672-2302.2025.02.001

• 手足口病防控专题 • 上一篇    下一篇

2010―2022年我国柯萨奇病毒A16型手足口病流行特征分析

刘言哲1(), 宋杨1, 刘凤凤1, 丁凡2, 沈若寒1, 孟欣1, 张彦平1, 常昭瑞1()   

  1. 1.中国疾病预防控制中心传染病管理处，传染病监测预警中国疾病预防控制中心重点实验室，传染病溯源预警与智能决策全国重点实验室，北京 102206
    2.中国疾病预防控制中心卫生应急中心
  • 收稿日期:2025-01-03 出版日期:2025-04-20 发布日期:2025-06-03
  • 通信作者: 常昭瑞，E-mail: changzr@chinacdc.cn
  • 作者简介:刘言哲，女，硕士在读，研究方向：公共卫生、流行病与卫生统计学。E-mail: liuyz@chinacdc.cn
  • 基金资助:
    中国疾病预防控制中心公共卫生应急反应机制的运行(102393220020010000017)

Epidemiological characteristics of hand, foot and mouth disease caused by coxsackievirus A16 in China, 2010-2022

LIU Yanzhe1(), SONG Yang1, LIU Fengfeng1, DING Fan2, SHEN Ruohan1, MENG Xin1, ZHANG Yanping1, CHANG Zhaorui1()   

  1. 1. Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention; National Key Laboratory of Intelligent Tracking and Forecasting for Infections Disease, Beijing 102206, China
    2. Public Health Emergency Center, Chinese Center for Disease Control and Prevention
  • Received:2025-01-03 Online:2025-04-20 Published:2025-06-03
  • Contact: CHANG Zhaorui, E-mail: changzr@chinacdc.cn

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摘要：

目的 分析我国柯萨奇病毒A16型（CVA16）手足口病流行特征，为制定手足口病防控策略和措施提供参考。方法 收集2010—2022年我国31个省（自治区、直辖市）手足口病监测网络的病原学监测数据。采用描述流行病学方法分析监测病例中CVA16的流行病学特征。结果 2010—2022年，我国手足口病病原学监测总病例数为1 150 953例，阳性755 660例，阳性总检出率为65.66%；其中重症（含死亡）病例71 748例，阳性54 304例，阳性检出率为75.69%。病原学阳性病例中，CVA16病例数历年构成比未发现趋势性变化（χ2趋势=0.01，P>0.05），肠道病毒71型（EV-A71）构成比总体呈下降趋势（χ2趋势=113 262.42，P<0.01），其他肠道病毒构成比总体呈上升趋势（χ2趋势=81 714.46，P<0.01）。CVA16总阳性检出率为17.05%（196 273/1 150 953），其中重症（含死亡）病例阳性检出率为6.03%（4 324/71 748）；重症（含死亡）病例的CVA16阳性检出率在2010—2015年较低（年均4.47%），2016—2022年上升（年均11.56%）。时间分布上，CVA16发病呈单峰分布，高峰为3—7月；南方地区发病高峰早于北方地区。人群分布上，男性和女性CVA16病例数分别为120 129例（占61.21%）和76 144例（占38.79%），阳性检出率分别为17.20%和16.82%（χ2=29.29，P<0.01）；年龄以0~5岁儿童为主，占91.63%（179 837/196 273）。轻症病例中不同省份的CVA16阳性检出率差异较小，重症（含死亡）病例的差异较大。结论 我国手足口病病例中CVA16的构成比和阳性检出率整体稳定，但重症病例中阳性检出率有所上升。需持续监测手足口病病原体变化，关注CVA16流行趋势，加强高发区域和高风险人群防控，加快含CVA16的多价疫苗的研发。

关键词: 手足口病, 柯萨奇病毒A16型, 流行特征, 病原学监测

Abstract:

Objective To analyze the epidemiological characteristics of coxsackievirus A16 (CVA16)-associated hand, foot and mouth disease (HFMD) in China for evidences to inform targeted prevention and control strategies and measures. Methods Virological surveillance data on HFMD were retrieved from 31 provincial-level administrative divisions (provinces, autonomous regions, and municipalities) in China between 2010 and 2022. Descriptive epidemiology was used to analyze the epidemiological characteristics of CVA16-associated HFMD cases identified through the national surveillance network. Results From 2010 to 2022, virological surveillance of HFMD in China recorded 1 150 953 cases, in whom 755 660 were laboratory-confirmed positives, with an overall positivity rate being 65.66%. There were 71 748 severe (including fatal) cases, among which 54 304 were positive, with a positive detection rate of 75.69%. No significant trend was observed in the annual proportion of CVA16 among positive cases (χ2trend=0.01, P>0.05). In contrast, EV-A71 showed a significant decline (χ2trend=113 262.42, P<0.01), whereas other enteroviruses exhibited an upward trend (χ2trend=81 714.46, P<0.01). The overall CVA16 detection rate was 17.05% (196 273/1 150 953), in which positive detection rate was 6.03% (4 324/71 748) for severe cases (including deaths). The positive rate of CVA16 was the lowest (4.47% on average yearly) in 2010-2015 in severe cases (including deaths), and increased to 11.56% on average between 2016 and 2022. By temporal distribution, CVA16-associated HFMD displayed a unimodal seasonal pattern, peaking annually from March to July, with southern regions experiencing earlier outbreaks than northern areas. By population distribution, males and females accounted for 61.21% (120 129/196 273) and 38.79% (76 144/196 273) of the CVA16 cases, with detection rates of 17.20% and 16.82%, respectively (χ2=29.29, P<0.01). The infection was dominated in children aged 0-5 years (91.63%, 179 837/196 273). Provincial variation in CVA16 detection was minimal among mild cases but substantial for severe/fatal cases. Conclusion In China, the proportional contribution of CVA16 and its overall positive detection rate among HFMD cases remained stable. However, a significant increase in positive detection rates was observed specifically in severe cases. These findings highlight the necessity for sustained virological surveillance of HFMD pathogens, continuous monitoring of CVA16 transmission dynamics, strengthened prevention and control measures in high-incidence regions and high-risk populations, and expedited development of multivalent vaccines incorporating CVA16.

Key words: Hand, foot and mouth disease, Coxsackievirus A16, Epidemiological characteristics, Pathogenic surveillance

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