浙江省宁波市2008-2011年手足口病流行病学及病原学特征分析  

Epidemioiogical and etiological characteristics of hand-foot-mouth disease in Ningbo, Zhejiang province, 2008-2011

作　　者：许国章[1] 倪红霞[1] 易波[1] 贺天锋[1] 董红军[1] 方挺[1] 顾文珍[1] 谢蕾[1] 

机构地区：[1]浙江省宁波市疾病预防控制中心,315010

出　　处：《中华流行病学杂志》2013年第4期361-365,共5页Chinese Journal of Epidemiology

基　　金：浙江省医药卫生科技计划项目（2009A190）;宁波市科技计划项目（2009C50008） （感谢慈溪、余姚市和鄞州区疾病预防控制中心的支持和帮助）

摘　　要：目的分析2008-2011年宁波市手足口病流行特征。方法从疾病监测信息报告管理系统获取宁波市2008-2011年手足口病资料，运用描述流行病学方法进行分析。对粪便标本采用RT-PCR扩增基因序列测定，并利用生物学软件分析。结果2008-2011年宁波市共报告手足口病病例37524例，其中重症196例，死亡12例，年均发病率为145．26／10万，病死率为0．03％。〈5岁儿童占报告病例的95．89％，散居儿童占64．10％；各地区发病均处于较高水平，其中宁海、象山县为发病率最高的地区，发病高峰在4—7月，男性多于女性。实验室确诊2394例，肠道病毒（EV）71型是主要的病毒株，进化树分析表明宁波市手足口病EV71分离株属于C4a进化分支，其流行和传播存在多个传播链。Cox A16株同时包含B1a和B1b两条进化分支共同流行。健康儿童EV71中和抗体阳性率为53．48％，GMT为11．23（8．33～14．98）；Cox A16中和抗体阳性率为63．18％．GMT为12．61（6．70～16．52）。结论宁波市手足口病疫情处于高流行态势，〈5岁散居儿童是主要发病人群，EV71为优势株；EV71毒株为C4a亚群，CoxA16毒株为B1基因亚型，与中国大陆优势株流行趋势一致。Objective To analyze the epidemiological characteristics of hand foot and mouth disease （HFMD） in Ningbo. Methods A descriptive analysis was conducted through the surveillance data of HFMD in Ningbo, Zhejiang province, from 2008 to 2011. Genes on EV71 and Cox A16 were amplified with RT-PCT from the stool samples of HFMD patients. Sequences were analyzed by bioinformatics software. Results 37 524 cases of HFMD were reported from 2008 to 2011, including 196 severe cases and 12 deaths. The reported incidence was 145.26 per 100 000 and the case fatality was 0.03%. Cases in children aged 5 or younger accounted for 95.89%, and the scattered cases accounted for 64.10%. Xiangshan and Ninghai counties had the highest incidence rates in Ningbo. The peak of incidence was from April to July. The number of male patients was obviously higher than females. 2394 cases of HFMD were laboratory confirmed and EV71 with the predominant epidemic strain. Data from phylogenetic analysis revealed that EV71 isolated from HFMD patients in Ningbo belonged to C4a evolution branch of C4 sub-genotype, with several transmission chains. Cox A16 belonged to B1 evolution branch. 53.48% of the healthy children in Ningbo showed EV71 antibody positive. The geometric mean of the antibody titer （GMT） was 11.23 （8.33-14.98） in healthy children. Cox A16 antibody was detected at 63.18% of the healthy children in Ningbo. GMT in healthy children was 12.61 （6.70-16.52）. Conclusion HFMD was highly endemic in Ningbo, with children under 5 years old were at high-risk. The major etiologic agent was EV71 which belonged to C4a in the C4 sub-genotypes. Cox A16 belonged to the B1 evolution branch, which were in line with the predominant virus circulating in the mainland of China.

关 键 词：手足口病 流行特征 肠道病毒71型 柯萨奇病毒A16型 

分 类 号：R725.1[医药卫生—儿科]