2009—2024年海宁市<7岁儿童手足口病流行特征及发病趋势预测

doi:10.12183/j.scjpm.2026.0357

摘要/Abstract

摘要： 目的描述2009—2024年海宁市<7岁儿童手足口病的流行特征,并预测2025年发病趋势,为制定防控策略提供科学依据。方法收集中国疾病预防控制中心传染病报告信息管理系统中海宁市2009—2024年<7岁儿童手足口病发病资料,采用描述性统计学方法和Joinpoint回归模型分析疾病流行特征,采用季节性自回归求和移动平均（seasonal auto regressive integrated moving average,SARIMA）模型对发病率进行建模与预测。结果 2009—2024年海宁市累计报告<7岁儿童手足口病20 847例,年均发病率为2 507.04/10万。时间分布上,呈现5—7月和9—11月双高峰模式。一周各天的平均发病率差异有统计学意义（χ²=60.786,P<0.05）,其中周一最高（393.25/10万）,随后呈下降趋势（χ²_趋势=36.522,P<0.05）。发病年份呈隔年交替模式,2009—2018年偶数年高发,2019—2024年则表现为奇数年高发。病例以1~<4岁婴幼儿为主,占62.54%（13 037例）。1~<2岁组发病率最高,为4 327.60/10万,后随年龄增加呈下降趋势（χ²_趋势=3 143.740,P<0.05）。男童发病率（2 865.06/10万）显著高于女童（2 124.34/10万,χ²=466.132,P<0.05）。EV-A71为优势病原体（38.38%）。SARIMA（2,0,0）（0,1,1）₁₂为最佳拟合模型,预测2025年发病率将高于2024年,且呈双峰分布。结论海宁市<7岁儿童手足口病发病率具有明显的周期性,1~<2岁散居儿童为高危人群,EV-A71为优势病原体。SARIMA模型能有效预测其短期发病趋势。建议加大EV-A71疫苗宣传力度,强化重点人群和地区的疫情监测与防控干预措施。

关键词: 手足口病, 儿童, 流行特征, SARIMA模型

Abstract: Objective To describe the epidemiological characteristics of hand, foot, and mouth disease (HFMD) among children under seven years of age in Haining from 2009 to 2024 and to forecast the incidence trend for 2025, thereby providing a scientific basis for the formulation of prevention and control strategies. Methods Data on HFMD cases in children under seven in Haining from 2009 to 2024 were collected from the Information Management System for Infectious Disease Reporting of the Chinese Center for Disease Control and Prevention. Descriptive statistical methods and a Joinpoint regression model were employed to analyze the epidemiological characteristics of the disease. A Seasonal Autoregressive Integrated Moving Average (SARIMA) model was developed to model and forecast the incidence rate. Results A cumulative total of 20 847 HFMD cases were reported in Haining from 2009 to 2024 among children under seven, with an average annual incidence rate of 2 507.04 per 100 000 population. Regarding temporal distribution, the incidence exhibited a bimodal pattern with peaks occurring from May to July and from September to November. A statistically significant difference was observed in the average daily incidence across the week (χ²=60.786, P<0.05), with the highest incidence on Mondays, followed by a decreasing trend (χ² for trend=36.522, P<0.05). The annual incidence demonstrated an alternating pattern, with even-numbered years showing higher incidence from 2009 to 2018, whereas odd-numbered years exhibited higher incidence from 2019 to 2024. Cases were predominantly concentrated in infants and toddlers aged 1 to <4 years, accounting for 62.54% (13 037 cases) of the total. The 1 to <2 years age group had the highest incidence rate at 4 327.60 per 100,000, which subsequently decreased with advancing age (χ² for trend=3 143.740, P<0.05). The incidence rate in boys (2 865.06 per 100 000) was significantly higher than that in girls (2 124.34 per 100,000) (χ²=466.132, P<0.05). Enterovirus A71 (EV-A71) was identified as the predominant pathogen (38.38%). The SARIMA(2,0,0)(0,1,1)₁₂model was determined to be the optimal fit, forecasting that the incidence in 2025 will exceed that of 2024 and will likewise display a bimodal distribution. Conclusion The incidence of HFMD in children under seven years of age in Haining demonstrates clear periodicity. Dispersed children aged 1 to <2 years constitute the highest-risk population, and EV-A71 is the dominant etiological agent. The SARIMA model proves effective for short-term forecasting of incidence trends. It is recommended that public health campaigns for the EV-A71 vaccine be intensified and that surveillance, prevention, and control interventions be enhanced for key populations and regions.

Key words: Hand, foot, and mouth disease, Children, Epidemiological characteristics, SARIMA model

中图分类号:

R512.5

赵天旺, 高雨, 李敏超. 2009—2024年海宁市<7岁儿童手足口病流行特征及发病趋势预测[J]. 华南预防医学, 2026, 52(4): 357-363.

Zhao Tianwang, Gao Yu, Li Minchao. Epidemiological characteristics and incidence trend prediction of hand, foot, and mouth disease among children under 7 years of age in Haining, 2009-2024[J]. South China Journal of Preventive Medicine, 2026, 52(4): 357-363.

参考文献

[1] Cox B, Levent F.Hand, foot, and mouth disease[J]. JAMA, 2018, 320(23): 1-2.
[2] Yang Qx, Liu F, Chang L, et al.Molecular epidemiology and clinical characteristics of enteroviruses associated HFMD in Chengdu, China, 2013-2022[J]. Virol J, 2023, 20(1): 202.
[3] Zhu Py, Ji Wq, Li D, et al.Current status of hand-foot-and-mouth disease[J]. J Biomed Sci, 2023, 30(1): 15.
[4] 熊华威, 梅树江, 路滟, 等. 2013—2017年深圳市手足口病聚集性疫情流行病学和病原学特征[J]. 职业与健康, 2019, 35(13): 1795-1798.
[5] Hyndman Rj, Khandakar Y.Automatic time series forecasting: The forecast package for R[J]. J Stat Softw, 2008, 27(3): 1-22.
[6] 常昭瑞, 张静, 孙军玲, 等. 中国2008—2009年手足口病报告病例流行病学特征分析[J]. 中华流行病学杂志, 2011, 32(7): 676-680.
[7] Qiu H, Zhao H, Xiang H, et al.Forecasting the incidence of mumps in Chongqing based on a SARIMA model[J]. BMC Public Health, 2021, 21(1): 373.
[8] Chicco D, Warrens Mj, Jurman G.The coefficient of determination R-squared is more informative than SMAPE, MAE, MAPE, MSE and RMSE in regression analysis evaluation[J]. PeerJ Comput Sci, 2021, 7: e623.
[9] Atchadé Mn, Sokadjo Ym, Moussa Ad, et al.Cross-validation comparison of COVID-19 forecast models[J]. SN Comput Sci, 2021, 2(4): 296.
[10] Nann D, Walker M, Frauenfeld L, et al.Forecasting the future number of pertussis cases using data from Google Trends[J]. Heliyon, 2021, 7(11): e08386.
[11] 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.
[12] 钱晓萍, 凌健, 刘腾. 吴兴区6岁以下儿童手足口病流行特征分析[J]. 预防医学, 2023, 35(3): 243-245, 249.
[13] 陈诹, 王莉红, 刘丹, 等. 2015—2018年上海市浦东新区手足口病空间特征分析[J]. 公共卫生与预防医学, 2020, 31(2): 50-53.
[14] 李明阳, 程晓庆, 魏叶, 等. 2010—2022年江苏省手足口病暴发疫情流行病学特征及其影响因素分析[J]. 中国公共卫生, 2024, 40(3): 336-341.
[15] Chen B, Yang Y, Xu X, et al.Epidemiological characteristics of hand, foot, and mouth disease in China: A meta-analysis[J]. Medicine (Baltimore), 2021, 100(20): e25930.
[16] 史珊珊, 周振宇. 2012—2021年浙江省余姚市手足口病季节性特征分析[J]. 疾病监测, 2022, 37(8): 1069-1072.
[17] 赵跃媛, 王恒学, 马涛, 等. 2014—2023年江苏省南京市6岁以下儿童手足口病时空聚集及流行强度分析[J]. 疾病监测, 2025, 40(6): 722-727.
[18] 庞孟涛, 李傅冬, 林君芬, 等. 2016—2019年浙江省手足口病流行特征[J]. 预防医学, 2022, 34(3): 307-310.
[19] 王浩权, 马飞飞, 龚刚, 等. 2015—2020年嘉定区手足口病流行特征[J]. 预防医学, 2021, 33(10): 1065-1067, 1071.
[20] 刘立立, 刘志科, 张良, 等. 2016—2019年宁波市5岁及以下儿童手足口病流行病学特征[J]. 北京大学学报(医学版), 2021, 53(3): 491-497.
[21] 孙巍, 陈淑红, 华华, 等. 2018—2019年黑龙江省手足口病疫情特征分析[J]. 中国公共卫生管理, 2021, 37(6): 796-798, 802.
[22] 孔志芳, 杨斌, 章海斌, 等. 2009—2018年浙江省宁海县手足口病流行特征及病原学分析[J]. 中国医院统计, 2019, 26(5): 373-376, 380.
[23] 杨芬, 梁文佳, 孙立梅, 等. 广东省EV71疫苗接种水平与手足口病流行分析[J]. 中国公共卫生, 2020, 36(3): 351-354.
[24] Cong J, Ren M, Xie S, et al.Predicting seasonal influenza based on SARIMA model, in China's mainland from 2005 to 2018[J]. Int J Environ Res Public Health, 2019, 16(23): 4760.
[25] Martinez Ez, Silva Ea, Fabbro Al.A SARIMA forecasting model to predict the number of cases of dengue in Campinas, State of São Paulo, Brazil[J]. Rev Soc Bras Med Trop, 2011, 44(4): 436-440.
[26] Ma Y, Xu S, Dong A, et al.Epidemiological characteristics, spatial clusters and monthly incidence prediction of hand, foot and mouth disease from 2017 to 2022 in Shanxi Province, China[J]. Epidemiol Infect, 2023, 151: e54.
[27] 卢振伟, 潘沛江, 郑志刚, 等. 广西手足口病与气象因素的相关性研究及发病预测模型构建[J]. 热带医学杂志, 2023, 23(3): 317-320, 326.
[28] Wang P, Goggins Wb, Chan Ey.Hand, foot and mouth disease in Hong Kong: A time-series analysis on its relationship with weather[J]. PLoS One, 2016, 11(8): e0161006.
[29] Chen Y, Sun W, Ling F, et al.Seasonality and meteorological factors associated with different hand, foot, and mouth disease: Serotype-specific analysis from 2010 to 2018 in Zhejiang Province, China[J]. Front Microbiol, 2022, 13: 901508.