Objective To ascertain the composition change about hand, foot and mouth disease(HFMD) and master the epidemic rules of the main pathogen agents in Shanghai area between 2011 and 2014, then to provide reference for HFMD prevention and control in Shanghai.

Methods Specimens were collected from children who were diagnosed with HFMD in two sentinel hospitals between January 2011 and December 2014.Specimen types included throat swab, feces, herpes fluid and cerebrospinal fluid.The nucleic acid of specimens was detected by universal enterovirus and then by specific typing method. HFMD pathogen spectrum was drawn in Shanghai area from 2011 to 2014, and the epidemic rules of the main pathogenic agents analyzed.

Results We collected 4 088 specimens from a total number of 2 764 cases of HFMD in Shanghai.Positive detection rate of universal enterovirus was 76.88%, while the positive detection rate of the main pathogenic agents:enterovirus 71 (EV71), type 16 of coxsackievirus group A (CA16), type 6 of coxsackievirus group A (CA6) and type 10 of coxsackievirus group A(CA10)was 35.78%, 16.53%, 17.55% and 2.28%, respectively.In 2011, HFMD in Shanghai were mainly caused by EV71 and CA16.However, in 2012 the composition ratio of EV71 declined and the composition ratio of CA6 increased.From October 2012 to September 2013, CA6 showed high prevalence.In 2013 and 2014, the main pathogenic agents were EV71 and CA6.The epidemic CA6 strains in Shanghai area from 2014 to 2015 belonged to D7 subtype.

Conclusion Pathogen spectrum of HFMD in Shanghai area changs year by year, and different type of enterovirus prevails alternately.The composition ratio of CA6 increases fast and become the main pathogenic agent of HFMD in Shanghai area.Continuous typing detection to monitor the main pathogenic agent, is of great significance in prevention and control of HFMD in Shanghai.