摘要以全国31个省、自治区和直辖市的手足口病为研究对象,估算各地手足口病传染率及其季节性,分析可能对季节性有影响的因素。采用时间序列SIR(Time Series Susceptible Infected Recovered (TSIR))模型,并应用马尔科夫蒙特卡洛方法 (Markov chain Monte Carlo,MCMC)估算模型中参数,分析各地月手足口病传染率及季节性,最后建立线性回归模型分析气候、假期和春运对手足口病传染率季节性的影响。结果表明中国各省手足口病传染率都有明显的季节性,根据传染率峰值发生时间,可以将各省归类到4个区域:东南地区峰值在2月~3月,各省传染率季节性多与春运有关;西北地区峰值在4月,传染率季节性主要受相对湿度和春运的影响;北方地区峰值在5月,季节性则受平均气温、暑假和春运的影响;西藏自治区峰值则在8月,其传染率季节性不受上述因素的影响。
Abstract：Based on the HFMD reported cases in 31 provinces, autonomous regions and municipalities of China, this paper estimated the transmission rate of HFMD and its seasonality, then analyzed possible related factors. The Time Series Susceptible Infected Recovered (TSIR) model was established to examine the HFMD transmission rate, and the parameters in the TSIR model were estimated by Markov chain Monte Carlo (MCMC). We also established a linear regression model to analyze the effects of climate factors, school terms and the spring festival travel rush on the transmission rate of HFMD. The results show that the HFMD transmission rate in all provinces of China has obvious seasonality. According to the peak time of HFMD transmission rate, the provinces can be divided into four regions: the peak period of HFMD transmission rate in the southeast region is from February to March, which is affected by the spring festival travel rush; the peak time in the northwest region is April and its seasonality is mainly affected by relative humidity and spring Festival travel rush; in the northern region, the peak period happens in May, which is associated with average temperature, summer vacation and spring festival travel rush; the peak of Tibet Autonomous Region is in August. The seasonality of its isn’t affected by climate or the contact rate.
王燕芬, 王旭峰, 赵继军. 中国各省、自治区与直辖市手足口病传染率分析[J]. 复杂系统与复杂性科学, 2019, 16(3): 79-86.
WANG Yanfen, WANG Xufeng, ZHAO Jijun. Analysis of Transmission Rate of Hand, Foot and Mouth Disease in Provinces, Autonomous Regions and Municipalities of China. Complex Systems and Complexity Science, 2019, 16(3): 79-86.
[1]Xing W, Liao Q, Viboud C, et a1. Hand, foot, and mouth disease in China, 200812: an epidemiological study [J]. Lancet Infectious Diseases, 2014,14(4): 308-318. [2]Wang B, Li J, Wang Y, et al. Understanding the epidemiological characteristics of EV71 and CVA16 infection to aid the diagnosis and treatment of hand, foot, and mouth disease [J]. Journal of Medical Virology, 2018, 91(2): 201-207. [3]Chang L Y, Lin T Y, Huang Y C, et al. Comparison of enterovirus 71 and coxsackie-virus A16 clinical illnesses during the Taiwan enterovirus epidemic, 1998 [J]. Pediatric Infectious Disease Journal, 1999, 18(12): 1092-6. [4]Zhao J, Jiang F, Zhong L, et al. Age patterns and transmission characteristics of hand foot and mouth disease in China [J]. BMC Infectious Diseases, 2016, 16(1): 691. [5]仲连发, 张志诚, 赵继军. 基于年龄结构的中国大陆手足口病流行特性的分析[J]. 中华疾病控制杂志, 2015, 19(7): 651-654. Zhong Lianfa, Zhang Zhicheng, Zhao Jijun. Analysis of epidemiological characteristics of hand, foot and mouth disease in mainland China based on age structure[J]. Chinese Journal of Disease Control, 2015, 19(7): 651-654. [6]Xing W, Liao Q, Viboud C, et al. Hand, foot, and mouth disease in China, 2008-12: an epidemiological study[J]. The Lancet Infectious Diseases, 2014, 14(4): 308-318. [7]赵佳楠, 薛超, 仲连发, 等. 重庆市手足口病接触率及感染力分析[J]. 科学通报, 2016, 61(22): 2475-2482. Zhao Jianan, Xue Chao, Zhong Lianfa, et al. Transmission rate and contact force analysis of hand foot and mouth disease in Chongqing [J]. Chinese Science Bulletin, 2016, 61(22): 2475-2482. [8]王燕芬,王旭峰,赵继军. 中国部分省份手足口病传染率分析[J]. 中华疾病控制杂志, 2019, 23(5): 540-544. Wang Yanfen, Wang Xufeng, Zhao Jijun. Analysis of the infection rate of hand, foot and mouth disease in some provinces of China[J]. Chinese Journal of Disease Control, 2019, 23(5): 540-544. [9]Keeling M J, Rohani P. Modeling Infectious Diseases in Humans and Animals [M]. Princeton: Princeton University Press, 2008: 864-865. [10] Ramsay M, Gay N, Miller E, et al. The epidemiology of measles in England and Wales: rationale for the 1994 national vaccination campaign [J]. Communicable Disease Report. CDR Review, 1994, 4(12): R141-6. [11] Rohani P, Zhong X, King A A. Contact network structure explains the changing epidemiology of pertussis[J]. Science, 2010; 330: 982-985. [12] Metcalf C J E, Bjornstad O N, Grenfell B T, et al. Seasonality and comparative dynamics of six childhood infections in pre-vaccination Copenhagen [J]. Proceedings of the Royal Society of London B: Biological Sciences, 2009, 276(1676): 4111-4118. [13] Jackson C, Mangtani P, Fine P, et al. The effects of school holidays on transmission of varicella zoster virus, England and Wales, 1967-2008 [J]. Plos One, 2014, 9(6): e99762. [14] Joseph C A, Noah N D. Epidemiology of chickenpox in England and Wales, 1967-85 [J]. British Medical Journal, 1988, 296(6623): 673-676. [15] Boeckel T P V, Takahashi S, Liao Q, et al. Hand, foot, and mouth disease in China: critical community size and spatial vaccination strategies [J]. Scientific Reports, 2016, 6: 25248. [16] Sumi A, Toyoda S, Kanou K, et al. Association between meteorological factors and reported cases of hand, foot, and mouth disease from 2000 to 2015 in Japan [J]. Epidemiology & Infection, 2017, 145(14): 2896-2911. [17] Bo Y C, Song C, Wang J, et al. Using an autologistic regression model to identify spatial risk factors and spatial risk patterns of hand, foot, and mouth disease (HFMD) in Mainland China. BMC Public Health 2014, 14(1): 1-13. [18] Ling H Y, Joacim R, Nawi N, et al. Short term effects of weather on hand, foot and mouth disease [J]. Plos One, 2011, 6(2): e1 6796. [19] Mahmud A S, Metcalf C J E, Grenfell B T. Comparative dynamics, seasonality in transmission, and predictability of childhood infections in Mexico [J]. Epidemiology & Infection, 2017, 145(3): 607-625. [20] 陈佶, 范学志, 赵继军. 手足口病传染率季节性及其与人口流动的关系[J]. 复杂系统与复杂性科学, 2017, 14(3): 97-102. Chen Ji, Fan Xuezhi, Zhao Jijun. Transmission rate seasonality of hand foot and mouth disease and its relationship with population flux[J]. Complex Systems and Complexity Science, 2017, 14(3): 97-102. [21] Zhao J, Li X. Determinants of the transmission variation of hand, foot and mouth disease in China [J]. Plos One, 2016, 11(10): e0163789. [22] Ferrari M J, Grais R F, Bharti N, et al. The dynamics of measles in sub-Saharan Africa [J]. Nature, 2008, 451(7179): 679-684. [23] Bjørnstad O N, Grenfell B F F T. Dynamics of measles epidemics: estimating scaling of transmission rates using a time series SIR model [J]. Ecological Monographs, 2002, 72(2):169-184. [24] Bjornstad O N, Finkenstadt B F, Grenfell B T. Dynamics of measles epidemics: estimating scaling of transmission rates using a time series SIR model [J]. Ecological Monographs, 2002, 72(2): 169-184. [25] Wesolowski A, Metcalf C J E, Eagle N, et al. Quantifying seasonal population fluxes driving rubella transmission dynamics using mobile phone data [J]. Proceedings of the National Academy of Sciences, 2015, 112(35): 11114-11119. [26] Wei A J, Zhang X J, Wang J Y, et al. Dynamics analysis of an ebola epidemic model[J]. Acta Mathematica Scientia, 2017, 37A: 577-592. [27] Ferrari M J, Djibo A, Grais R F, et al. Rural-urban gradient in seasonal forcing of measles transmission in Niger [J]. Proceedings Biological Sciences, 2010, 277(1695): 2775-2782. [28] Li S, Ma C, Hao L, et al. Demographic transition and the dynamics of measles in six provinces in China: a modeling study [J]. Plos Medicine, 2017, 14(4): e1002255.
