甘肃省2013-2015年手足口病流行特征及病原学分析  

Epidemic and etiological characteristics of hand, foot and mouth disease in Gansu province during 2013-2015

作　　者：陈建华[1] 武海卓 张勇[2] 于德山[1] 成瑶[1] 孟蕾[1] 

机构地区：[1]甘肃省疾病预防控制中心,兰州730000 [2]中国疾病预防控制中心病毒病预防控制所卫生部医学病毒和病毒病重点实验室,北京102206

出　　处：《中华实验和临床病毒学杂志》2017年第2期108-112,共5页Chinese Journal of Experimental and Clinical Virology

基　　金：甘肃省卫生行业科研管理项目（GWGL2014-75）;国家科技重大专项传染病监测技术平台项目（2012ZX10004-208）

摘　　要：目的 分析2013-2015年甘肃省手足口病流行特征及病原学特征,为制定有效的防控策略提供依据.方法 采用描述性流行病学方法分析;采集的临床标本用Real-time PCR法检测肠道病毒核酸,病毒分离采用RD和HEp-2两种细胞系,获得的毒株采用RT-PCR方法扩增全长VP1编码区,并进行核苷酸序列测定和分析.结果 2013-2015年共报告手足口病病例29 934例,其中重症病例81例, 死亡2例.全省14个市州均有发病,兰州市发病数最高为7 053例,占全省病例的23.56%,发病集中在 5-7月份,占全年病例的61.69%,男女性别比为1.5∶1,5 岁以下儿童发病占83.02%.对5 251例病例标本进行肠道病毒核酸检测,阳性2 972例（阳性率56.60%）;81例重症病例中肠道病毒核酸阳性55例（阳性率67.90%）;2例死亡病例均为EV71感染.分离到的341株病毒中,133株EV71的VP1基因分型均为C4a;134株CVA16中6株属于B1a,128株属于B1b.结论 2013-2015年甘肃省手足口病为5岁以下儿童感染率最高,病原构成中EV71和CVA16的比例较2013年前下降,非CVA16 和EV71的肠道病毒比例增加,发病率呈现波浪形变化.Objective To analyze the epidemiological and etiological characters of hand, foot and mouth disease （HFMD） in Gansu during 2013 to 2015 and provide evidence for the development of effective prevention and control measures.Methods The descriptive epidemiological analysis was used to analyze the data of HFMD, and the specimens were collected from hospitals to detect the pathogens by RT-PCR or Real-time RT-PCR.The nucleotide sequences of VP1 encoding region of virus strains were amplified by RT-PCR method, and determined and analyzed.Results Total of 29 934 HFMD cases were reported in Gansu from 2013 to 2015,including 81 severe cases and 2 deaths;the largest number occurred in Lanzhou was 7 053, accounting for 23.56% of the cases in the province.HFMD cases were mostly reported during May to July,accounted for 61.69% in total cases;the male to female ratio was 1.5：1, and most cases were under the age of five and accounted for 83.02%.A total of 5 251 laboratory confirmed cases were reported, of which the number of cases caused by human enterovirus （HEV） were 2 972, the positive rate was 56.60%.Among the severe 81 cases, the positive rate of HEV was 67.90%, and both of the 2 death cases were infected by EV71. 341 strains of viruses were isolated, the genotyping of VP1 encoding region showed that all the 133 EV71 were C4a;among the 134 CVA16 isolates, 6 were B1a and 128 were B1b.Conclusions In Gansu province, there is a high infection rate of HFMD in children under the age of five, the proportion of other HEV is more and more, and the incidence is related to the difference of pathogens that showed alternant epidemic characteristics.CVA16 and EV71 viruses have the phenomenon of alternating.

关 键 词：手足口病 流行病学 肠道病毒71型 柯萨奇病毒A组16型 肠道病毒 

分 类 号：R181.3[医药卫生—流行病学] R725.1[医药卫生—公共卫生与预防医学]