2008-2013年湖北省十堰地区手足口病病原谱动态分析  

Etiology of hand foot and mouth disease in Shiyan,Hubei,2008- 2013

作　　者：梅玉发[1] 杨小丽[2] 王喜云[1] 崔龙[1] 程时秀[1] 郑向梅[1] 

机构地区：[1]十堰市疾病预防控制中心,湖北十堰442000 [2]湖北医药学院附属太和医院,湖北十堰442000

出　　处：《疾病监测》2014年第6期437-440,共4页Disease Surveillance

摘　　要：目的分析十堰地区手足口病病原谱构成及其动态变化,为该病的预防控制提供参考。方法 2008年5月至2013年12月,从十堰市各县（市、区）收集2076例手足口病临床诊断病例标本,用一步法反转录聚合酶链反应（one-step RT-PCR）和实时荧光定量反转录聚合酶链反应（real-time RT-PCR）法进行手足口病毒核酸检测并分型,结合病例基本信息,对判定为手足口病的确诊病例,采用描述流行病学方法进行病原谱动态分析。结果 2008-2013年,肠道病毒71型（EV71）、柯萨奇病毒A组（Cox A16、Cox A6、Cox A10）及其他型人肠道病毒（EV）在手足口病确诊病例中的病原构成比依次为46.35%（24.19%~62.23%）、38.12%（13.06%~70.97%）、5.99%（0~13.06%）、3.75%（0~8.28%）和5.79%（1.37%~15.12%）。Cox A6与Cox A10致病对象为≤5岁婴幼儿;4-6月出现夏季流行高峰,10-11月出现冬季流行小高峰;各县（市、区）流行的手足口病毒均在4种以上,Cox A6所占比例持续上升,2013年达到13.06%。结论 2008-2013年十堰地区手足口病流行较为严重,病原体包括EV71、Cox A16、Cox A6、Cox A10等多种型别肠道病毒,EV71与Cox A16逐年交替维持着优势地位,Cox A6近2年有持续上升的趋势值得关注。国家在今后的疫情防控、疫苗策略和临床管理中,应高度重视手足口病持续流行过程中病原谱的变化。Objective To understand the etiology of hand foot and mouth disease（HFMD） in Shiyan,Hubei province and provide evidence for the prevention and control of HFMD. Methods A total of 2076 specimens were collected from clinical diagnosed HFMD cases in Shiyan from May 2008 to December 2013,the identification and subtying of the isolates were conducted with one-step RT-PCR or real-time fluorescent quantitative RT-PCR. Descriptive epidemiological analysis was conducted on the etiological detection data of laboratory confirmed HFMD cases. Results Laboratory detection indicated that HFMD was mainly caused by EV71,followed by Cox A16,Cox A6,Cox A10 and other enterovirus from 2008 to 2013,accounting for 46. 35%（24. 19%- 62. 23%）,38. 12%（13. 06%- 70. 97%）,5. 99%（0-13.06%）,3.75%（0-8.28%） and 5.79%（1.37%-15.12%） respectively. All the cases caused by Cox A6and Cox A10 were children aged ≤5 years. The incidence peak in summer was during April-June and the incidence subpeak in winter was during October-November. More than 4 types of pathogens circulated in all counties and districts.The proportion of the cases caused by Cox A6 increased steadily,reaching 13. 06% in 2013. Conclusion HFMD epidemic was serious in Shiyam during 2008- 2013. The predominant pathogens were EV71 and Cox A16 alternatively.Cox A6 caused cases increased in recent 2 years. It is necessary to pay close attention to the change of pathogen proportion of HFMD in the future prevention and control of HFMD.

关 键 词：手足口病 病原谱 肠道病毒71型 柯萨奇病毒A组16型 柯萨奇病毒A组6型 柯萨奇病毒A组10型 

分 类 号：R725.1[医药卫生—儿科]