錢燕琴 馬紀(jì)林

摘 要 目的：描述手足口?。℉and，foot and mouth disease，HFMD）在上海松江區(qū)各街道/鎮(zhèn)層面的流行病學(xué)與時(shí)空之間的分布特征。方法：從國家疾病監(jiān)測(cè)系統(tǒng)中收集2011-2020年HFMD監(jiān)測(cè)報(bào)告的數(shù)據(jù)來分析統(tǒng)計(jì)HFMD流行病集群和時(shí)空分布。結(jié)果：2011-2020年上海松江區(qū)HFMD的年均發(fā)病率為211.13/10萬，92.60%的HFMD病例發(fā)病年齡在0～6歲之間，患者中男性占60.08%。HFMD的季節(jié)性高峰期在5-10月。HFMD的發(fā)病在街道/鎮(zhèn)之間的分布是不均勻的，10年間有5個(gè)街道/鎮(zhèn)發(fā)病率高于全區(qū)平均水平。HFMD病例主要集中在城鄉(xiāng)邊緣地區(qū)與人口稠密地區(qū)。結(jié)論：每年5月至10月，上海松江區(qū)城鄉(xiāng)邊緣地區(qū)與人口稠密地區(qū)是HFMD的高發(fā)地區(qū)；學(xué)齡前兒童是重點(diǎn)防治人群。提示上海松江區(qū)HFMD的防控工作應(yīng)重點(diǎn)關(guān)注這些高危時(shí)段、高發(fā)地區(qū)和重點(diǎn)人群，注意公共衛(wèi)生資源的配置。

關(guān)鍵詞 手足口??；發(fā)病率；時(shí)空聚集

中圖分類號(hào)：R512.6 文獻(xiàn)標(biāo)志碼：A 文章編號(hào)：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?。╤and，foot and mouth disease，HFMD）是一種由腸道病毒71型和柯薩奇病毒A16型引起的常見腸道傳染病[1-2]。HFMD主要以發(fā)熱、口腔潰瘍、手腳和口腔皰疹的臨床表現(xiàn)為特征，主要是通過接觸患者的唾液、呼吸道飛沫、糞便、水泡液等的人與人之間直接傳播以及通過被污染的物品間接傳播。大多數(shù)有癥狀病例發(fā)生在0～5歲的兒童，但也可在較大年齡的兒童和成人中發(fā)病。大多數(shù)病例屬于自限性的，但少數(shù)病例可能出現(xiàn)嚴(yán)重的并發(fā)癥，包括神經(jīng)系統(tǒng)癥狀，如腦炎、腦膜炎甚至死亡[3-4]。在過去的10年中，包括中國在內(nèi)的東亞和東南亞地區(qū)出現(xiàn)了大量的HFMD暴發(fā)的報(bào)道[5-6]。2007年和2008年，山東和安徽省發(fā)生了大規(guī)模的HFMD暴發(fā)，導(dǎo)致了大量的聚集性病例和死亡[7-8]。衛(wèi)生部于2008年5月2日將HFMD列為丙類法定傳染病[9]。