Changing serotypes of hand, foot and mouth disease in Shanghai, 2017-2019.
Changing serotypes of hand, foot and mouth disease in Shanghai, 2017-2019.
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2017-2019年上海市手足口病血清型变化
DOI：
10.1186/s13099-022-00485-1
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发表时间：
2022-03-21
期刊：
影响因子：
4.2
通讯作者：
Lu Y
中科院分区：
文献类型：
--
作者：
Hu L;Maimaiti H;Zhou L;Gao J;Lu Y
手足口病（HFMD）是我国儿童常见的报告传染病，传染性极强。本研究旨在了解中国东部城市上海引入 EV-A71 疫苗后手足口病的流行情况和肠道病毒 (EV) 血清型。本研究于2017年5月至2020年10月期间共招募手足口病病例2271例。其中，男女比例为1.6:1，病例以1~4岁为主（63.1%）。所有年龄段的儿童从手足口病发病到首次就诊的时间跨度相对相似（P = 0.5192）。全年都有病例报告，高峰出现在夏季（2018年和2019年）和秋季（2017年），这与上海市以往报告的手足口病病例流行情况一致。在EV检测呈阳性的样本中（n = 1855），主要检测到CV-A6（71.1％），其次是CV-A16（14.2％）和EV-A71（7.0％）。值得注意的是，2019年感染EV-A71的手足口病病例有所增加。此外，9.2%的病例有合并症，主要是抽搐、支气管肺炎和肺炎；然而，它们与 EV 血清型无关。此外，31.2%（709/2271）的病例接种了EV-A71疫苗。根据发病是在接种疫苗之前还是之后，各组从接种疫苗到发病的时间跨度存在显着差异（P<0.001）。 CV-A6是上海地区手足口病疫情的优势EV血清型；此外，CV-A16 和 EV-A71 可能中等流行。 EV 血清型的变化趋势导致了手足口病流行的周期性。此外，无论 EV 血清型如何，少数手足口病病例可能患有合并症。 EV-A71疫苗的使用影响了手足口病的流行。与感染非EV-A71血清型的儿童相比，EV-A71疫苗的血清型特异性保护可能会促进感染EV-A71儿童的疫苗接种，这将进一步改变手足口病的流行情况。
Hand, foot, and mouth disease (HFMD) is a common reportable infectious disease that is highly contagious among children in China. This study aimed to characterize the epidemics of HFMD and the serotypes of enterovirus (EV) after the introduction of EV-A71 vaccines in Shanghai, a city in Eastern China. A total of 2271 HFMD cases were recruited in this study from May 2017 through October 2020. Among these cases, a male-to-female ratio of 1.6:1 was observed, and the cases were mainly in 1–4 years old (63.1%). Children of all ages had a relatively similar time span between the onset of HFMD and the initial medical visit (P = 0.5192). The cases were reported year-round with peaks in the summer (2018 and 2019) and fall (2017), which was consistent with previous epidemics of the reported HFMD cases in the Shanghai municipality. Among the specimens that tested positive for EV (n = 1855), CV-A6 was predominantly detected (71.1%), followed by CV-A16 (14.2%) and EV-A71 (7.0%). Notably, the number of HFMD cases infected with EV-A71 increased in 2019. Furthermore, 9.2% of the cases had comorbidities, mostly convulsion, bronchopneumonia, and pneumonia; however, they were not correlated with the EV serotypes. In addition, 31.2% (709/2271) of the cases were vaccinated with EV-A71 vaccines. The time span differed significantly between the time of vaccination and the onset of the disease across the groups based on whether the onset was before or after vaccination (P < 0.001). CV-A6 is the predominant EV serotype in the epidemic of HFMD in Shanghai; in addition, CV-A16 and EV-A71 may be moderately prevalent. The changing trends in the presence of EV serotypes contributes to the periodicity of the HFMD epidemic. In addition, the minority of HFMD cases may have comorbidities, regardless of the EV serotype. The use of the EV-A71 vaccine has affected the HFMD epidemic. And serotype-specific protection by the EV-A71 vaccine may promote vaccination in children infected with EV-A71 compared to those infected with non-EV-A71 serotypes, which would further change the epidemic scenario of HFMD.
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