上海市某医院2011-2014年手足口病病原谱及流行特征分析  

Analysis on the pathogen spectrum and epidemiologic characteristics of hand-foot-mouth disease in the children from a sentinel surveillance hospital during 2011-2014 in Shanghai

作　　者：蔡明毅[1] 赵文良[1] 沈琦[1] 王平[1] 何永频[1] 

机构地区：[1]上海市静安区疾病预防控制中心,上海200041

出　　处：《国际病毒学杂志》2015年第6期376-379,共4页International Journal of Virology

基　　金：上海市静安区卫生计生委重点学科项目（JWXK201203）

摘　　要：目的 了解上海市某医院接诊儿童手足口病监测病例的病原谱构成及其流行特征,为儿童手足口病的防控提供实验室依据.方法 依照上海市手足口病监测方案选择手足口病临床诊断患儿,并采集患者咽拭子和肛拭子标本,应用Realtime RT-PCR方法对肠道病毒属通用（EV）、肠道病毒71型（EV71）、柯萨奇病毒A16型（CA16）、柯萨奇病毒A6型（CA6）和柯萨奇病毒A10型（CA10）的核酸进行检测,对2011-2014年的检测结果进行分析.结果 在500例临床确诊患儿中,455例检出肠道病毒阳性,阳性率为90.80％;春夏季EV71和CA16检出率较高,秋冬季CA6和CA10检出率较高;引起手足口病的优势病原亚型在2013年由EV71/CA16转变为CA6;5岁及以下儿童占总阳性病例数的78.20％.结论 该哨点医院儿童手足口病的优势病原亚型2013年开始发生了明显改变,应加强对CA6等型别的监测.Objective To study the pathogen spectrum and epidemiological characteristics of hand -foot-mouse disease （HFMD） in Shanghai during 2011-2014, and to provide evidence-based data for HFMD control and prevention.Methods Throat and anal swabs were collected from the clinical-diagnosis HFMD patients in a sentinel surveillance hospital of Shanghai.Universal enterovirus, Enterovirus 71 （EV71）, Coxsackievirus A1 6, A10 and A6 were detected by real time RT-PCR.The results collected during 2011-2014 were analyzed epidemiologically.Results Four hundred and fifty-five were positive for enterovirus among 500 clinical diagnosis patients and the positive rate was 91.00%.The peak of detection rate of EV71 and CA16 appeared in summer （From May to August）, whereas the peak of CA6 and CA10 appeared in winter （October to December）.The predominant type of enterovirus changed from EV71 and CA16 to CA6 after the year 2013.The susceptible population of HFMD was also children aged ≤5 years, and the proportion of them among all subjects amounted to 78.20%.Conclusions The predominant type of pathogens of HFMD in children has changed after the year 2013 in the sentinel surveillance hospital of Shanghai.Monitoring on CA6 should be strengthened.

关 键 词：手足口病 儿童 病原谱 流行病学特征 

分 类 号：R725.1[医药卫生—儿科] R181.3[医药卫生—临床医学]