2011—2024年遂宁市手足口病病原学监测特征分析

doi:10.12183/j.scjpm.2026.1096

摘要/Abstract

摘要： 目的分析2011— 2024年遂宁市手足口病（HFMD）的病原学特征及流行规律,为优化防控策略提供科学依据。方法收集遂宁市HFMD临床诊断病例的咽拭子样本,采用实时荧光定量逆转录–聚合酶链反应法进行肠道病毒核酸检测。采用描述性流行病学方法,结合R 4.3.3软件分析手足口病病原学特征及变化趋势。结果 2011— 2024年,遂宁市累计采集手足口病病例咽拭子样本3 653例进行肠道病毒核酸检测,阳性2 380例,总阳性率65.15%。病原构成中其他型、CVA16和EV-A71分别占62.23%、31.81%和5.80%;另有0.17%为CVA16与EV-A71混合感染。2011— 2024年遂宁市HFMD优势病原不断变化：2019年后未再检出EV-A71,由CVA16与其他型每隔1~2年交替或共同流行。全年呈双峰流行（5— 7月和9— 11月）,其中EV-A71集中于3— 6月（76.09%）,CVA16和其他型的流行季与总体趋势一致。HFMD阳性病例主要集中在5岁以下儿童（92.02%）,但CVA16感染者中该年龄组的构成比（83.88%）显著低于其他型（96.02%）和EV-A71（93.48%,P< 0.01）。人群分布上,其他型和EV-A71以散居儿童为主（76.23%和62.32%）,而CVA16在幼托儿童中占比更高（55.88%,P< 0.01）。结论 2011— 2024年遂宁市手足口病病原谱发生转变,EV-A71基本消失,CVA16与其他型成为优势病原;且不同型别病原体的流行季节和易感人群存在差异。建议深化病原学监测,特别是加强对其他EV的分子分型,以提升防控工作的精准性。

关键词: 手足口病, 病原学监测, 流行病学, 肠道病毒

中图分类号:

R512.5

谭兴秀, 罗娇, 邓莹, 刘丰溢, 刘益昀, 王中, 刘文琪. 2011—2024年遂宁市手足口病病原学监测特征分析[J]. 华南预防医学, 2026, 52(9): 1096-1099.

Tan Xingxiu, Luo Jiao, Deng Ying, et al. Etiological surveillance characteristics of hand, foot and mouth disease in Suining, 2011-2024[J]. South China Journal of Preventive Medicine, 2026, 52(9): 1096-1099.

参考文献

[1] Li XW, Ni X, Qian SY, et al.Chinese guidelines for the diagnosis and treatment of hand, foot and mouth disease (2018 edition)[J]. World J Pediatr, 2018, 14(5): 437-447.
[2] Zhu P, Ji W, Li D, et al.Current status of hand-foot-and-mouth disease[J]. J Biomed Sci, 2023, 30(1): 15.
[3] Weng Y, Chen W, Huang M, et al.Epidemiology and etiology of hand, foot, and mouth disease in Fujian Province, 2008—2014[J]. Arch Virol, 2017, 162(2): 535-542.
[4] Hu Y, Xu L, Pan H, et al.Transmission center and driving factors of hand, foot, and mouth disease in China: A combined analysis[J]. PLoS Negl Trop Dis, 2020, 14(3): e80703.
[5] Xie J, Yang XH, Hu SQ, et al.Co-circulation of coxsackieviruses A-6, A-10, and A-16 causes hand, foot, and mouth disease in Guangzhou City, China[J]. BMC Infect Dis, 2020, 20(1): 271.
[6] Li J, Zhang C, Li Y, et al.Coxsackievirus A6 was the most common enterovirus serotype causing hand, foot, and mouth disease in Shiyan City, central China[J]. World J Clin Cases, 2022, 10(31): 11358-11370.
[7] Lee J, Kim M, Lim M, et al.Epidemiological and genetic characterization of coxsackievirus A6-associated hand, foot, and mouth disease in Gwangju, South Korea, in 2022[J]. Viruses, 2024, 16(3): 476.
[8] Sun Y, Cai J, Mao H, et al.Epidemiology of hand, foot and mouth disease and genomic surveillance of coxsackievirus A10 circulating in Zhejiang Province, China during 2017 to 2022[J]. J Clin Virol, 2023, 166: 105552.
[9] Puenpa J, Saengdao N, Khanarat N, et al.Evolutionary and genetic recombination analyses of coxsackievirus A6 variants associated with hand, foot, and mouth disease outbreaks in Thailand between 2019 and 2022[J]. Viruses, 2023, 15(1): 73.
[10] Chen Y, Chen S, Shen Y, et al.Molecular evolutionary dynamics of coxsackievirus A6 causing hand, foot, and mouth disease from 2021 to 2023 in China: Genomic epidemiology study[J]. JMIR Public Health Surveill, 2024, 10: e59604.
[11] Hong J, Liu F, Qi H, et al.Changing epidemiology of hand, foot, and mouth disease in China, 2013—2019: A population-based study[J]. Lancet Reg Health West Pac, 2022, 20: 100370.
[12] 张静, 李秀惠, 李丽, 等. 手足口病病原学和流行病学研究进展[J]. 中华流行病学杂志, 2022, 43(5): 771-783.
[13] 卫生部. 手足口病预防控制指南(2009版)[J]. 全科医学继续教育, 2010, 8(2): 125-127.
[14] 刘天, 赵婧, 阮德欣, 等. 2011—2022年荆州市手足口病病原学监测结果分析[J]. 华南预防医学, 2024, 50(5): 433-436.
[15] 张钟, 郑亚明, 姜黎黎, 等. 我国2015—2016年哨点监测手足口病病原学和并发症分析[J]. 中华流行病学杂志, 2019, 40(6): 627-632.
[16] 刘凤凤, 宋杨, 孟欣, 等. 2024年中国5省(直辖市)基于哨点医院的手足口病和疱疹性咽峡炎监测数据分析[J]. 疾病监测, 2025, 40(7): 858-864.
[17] 马智静, 武金娟, 吴海岚, 等. 中国手足口病流行病学特征的回顾性分析[J]. 中国生物制品学杂志, 2025, 38(2): 155-160.
[18] Liu F, Yi Y, Song Y, et al.Epidemiology of hand, foot, and mouth disease outbreaks before and during availability of EV-A71 vaccine in China's mainland: Analysis of outbreak surveillance data from 2011 to 2023[J]. Lancet Reg Health West Pac, 2025, 59: 101603.
[19] Li F, Wang D, Su F, et al.Epidemiological, etiological, and serological characteristics of hand, foot, and mouth disease in Guizhou Province, Southwest China, from 2008 to 2023[J]. PLoS Negl Trop Dis, 2025, 19(8): e13394.
[20] Dai B, Chen Y, Han S, et al.Epidemiology and etiology of hand, foot, and mouth disease in Zhengzhou, China, from 2009 to 2021[J]. Infect Med Beijing, 2024, 3(2): 100114.
[21] Wu B, Zhang X, Fu M, et al.Epidemiological trends of hand, foot, and mouth disease in children under age 10, Jiangning District, Jiangsu, China (2009-2023)[J]. BMC Infect Dis, 2025, 25(1): 886.
[22] 王元春, 姚亚雄, 王昱, 等. 2010—2024年甘肃省天水市手足口病病原学监测分析[J]. 疾病预防控制通报, 2025, 40(3): 47-51.