Epidemiological features and the results of pathogen surveillance in hand, foot and mouth disease in Kunming City from 2010 to 2024

doi:10.20199/j.issn.1672-2302.2025.02.005

Abstract

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

CLC Number:

R512.5，R181.3

DAI Min, ZHAO Zhenxi, ZHANG Xiaodie, ZHANG Xiaoqiao, XIE Pengliu, LING Jue, LU Yuan, MAO Zhipeng. Epidemiological features and the results of pathogen surveillance in hand, foot and mouth disease in Kunming City from 2010 to 2024[J]. Journal of Tropical Diseases and Parasitology, 2025, 23(2): 86-90,115.

Figures/Tables 6

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Figure 1

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References 22

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年份	人口数（人）	报告病例数（例）	重症病例数（例）	死亡病例数（例）	发病率（/10万）	重症率（/10万）	死亡率（/10万）	病死率（/万）
2010	6 022 630	17 652	513	10	293.09	8.52	0.17	5.67
2011	6 432 206	12 209	695	12	189.81	10.81	0.19	9.83
2012	6 462 810	18 190	387	3	281.46	5.99	0.05	1.65
2013	6 503 320	15 372	344	3	236.37	5.29	0.05	1.95
2014	6 533 910	24 056	1 130	0	368.17	17.29	0	0
2015	6 571 870	19 752	971	0	300.55	14.78	0	0
2016	6 677 001	20 173	478	0	302.13	7.16	0	0
2017	6 728 005	14 313	274	0	212.74	4.07	0	0
2018	6 782 970	24 002	357	0	353.86	5.26	0	0
2019	6 850 005	22 498	283	0	328.44	4.13	0	0
2020	6 949 997	16 020	86	0	230.50	1.24	0	0
2021	8 487 783	8 791	92	1	103.57	1.08	0.01	1.14
2022	8 468 423	12 691	66	1	149.86	0.78	0.01	0.79
2023	8 599 419	11 786	28	0	137.06	0.33	0	0
2024	8 680 047	9 770	14	0	112.56	0.16	0	0
合计	106 750 396	247 275	5 718	30	231.64	5.36	0.03	1.21

地区	报告病例数（例）	发病率（/10万）	重症病例数（例）	重症率（/10万）	死亡病例数（例）
官渡区	52 903	316.82	1 585	9.49	9
盘龙区	28 093	221.68	602	4.75	5
五华区	26 756	194.19	668	4.85	1
西山区	26 477	216.07	713	5.82	3
嵩明县	18 221	358.67	499	9.82	1
呈贡区	16 917	274.24	411	6.66	1
晋宁区	13 135	281.07	220	4.71	0
安宁市	12 633	217.12	139	2.39	1
石林彝族自治县	11 313	300.93	23	0.61	0
寻甸回族彝族自治县	11 235	158.91	224	3.17	4
宜良县	10 875	173.13	286	4.55	1
东川区	9 126	218.41	150	3.59	1
禄劝彝族苗族自治县	5 646	93.11	141	2.33	3
富民县	3 945	175.04	57	2.53	0

年龄（岁）	轻症				重症				死亡
年龄（岁）	EV-A71	CVA16	其他肠道病毒	小计	EV-A71	CVA16	其他肠道病毒	小计	EV-A71	CVA16	其他肠道病毒	小计
<1	343	477	771	1 591	93	18	86	197	3	0	0	3
1	1 723	2 189	2 365	6 277	446	94	365	905	8	0	0	8
2	1 801	2 158	1 587	5 546	343	65	162	570	1	0	0	1
3	2 159	2 515	2 134	6 808	259	51	124	434	2	0	0	2
4	1 377	1 507	1 550	4 434	115	33	56	204	0	0	1	1
≥5	1 279	1 383	1 572	4 234	112	29	26	167	0	0	0	0
合计	8 682	10 229	9 979	28 890	1 368	290	819	2 477	14	0	1	15

变量	B值	SE值	Wald χ²值	P值	OR（95%CI）值	变量	B值	SE值	Wald χ²值	P值	OR（95%CI）值
性别			25.799	<0.05		幼托儿童	2.584	1.000	6.683	0.010	13.250（2.981，232.995）
女性					1	学生	2.111	1.003	4.431	0.035	8.257（1.836，145.648）
男性	0.141	0.028			1.151（1.090，1.215）	发病后就诊时间（d）			3 057.487	<0.05
年龄（岁）			1 091.628	<0.05		≥4
≥5						0	-2.448	0.058	1 802.188	<0.05	0.086（0.077，0.097）
<1	0.786	0.087	82.116	<0.05	2.195（1.853，2.604）	1	-1.632	0.039	1 755.253	<0.05	0.196（0.181，0.211）
1	0.742	0.078	91.571	<0.05	2.099（1.806，2.448）	2	-1.098	0.038	840.128	<0.05	0.333（0.310，0.359）
2	0.517	0.077	45.445	<0.05	1.677（1.445，1.951）	3	-0.650	0.041	248.669	<0.05	0.522（0.481，0.566）
3	0.370	0.070	27.571	<0.05	1.447（1.263，1.664）	现住址类别			79.331	<0.05
4	0.083	0.079	1.119	0.290	1.087（0.932，1.269）	城区					1
职业			100.504	<0.05		郊县区	0.263	0.030			1.301（1.228，1.379）
其他职业						常量	-6.084	0.998	37.148	<0.05	0.002（0.000，0.010）
散居儿童	2.975	1.000	8.846	0.003	19.594（4.396，344.843）