菏泽市2013～2017年手足口病病毒学监测分析  

Virology monitoring and analysis of hand-foot-and-mouth disease in 2013-2017 in Heze city

作　　者：刘雅娟[1] 刘启林[1] LIU Yajuan;LIU Qilin(Clinical Laboratory,Heze Center for Disease Control and Prevention in Shandong Province,Heze 274000,China)

机构地区：[1]山东省菏泽市疾病预防控制中心检验科,山东菏泽274000

出　　处：《中国现代医生》2018年第22期131-135,共5页China Modern Doctor

摘　　要：目的探讨菏泽市2013~2017年手足口病流行病毒类型,为菏泽市手足口病疫情的防控和实施策略提供科学依据。方法 2013~2017年菏泽市各县区手足口病定点医疗单位收集的临床诊断病例的粪便或肛拭子标本,提取病毒核酸,应用实时荧光定量PCR进行病毒的核酸检测;用描述性流行病学方法分析流行病学特征。结果2013~2017年共收集样本2751份,其中阳性样本2294份,阳性率为83.39%;EV71阳性样本1111份,阳性率为40.39%;CA16阳性样本387份,阳性率为14.08%;其他肠道病毒阳性样本796分,阳性率为28.93%。2013年、2015年优势株为EV71;2014年优势株为CA16;2016、2017年以其他肠道病毒型为优势株。不同年龄组、性别、季节分布差异有显著性(P<0.05)。各年手足口病毒型别分布差异有统计学意义(P<0.05)。结论 2013~2017年菏泽市手足口病流行病毒类型从高到低分别是EV71、其他肠道病毒和CA16。EV71是引起重症病例的主要病原体。在高发季节前,应加强托幼机构及散居儿童的卫生健康教育和防控力度,提前做好低幼儿童的疫苗宣传及接种工作;强化手足口病监测力度。Objective To investigate the epidemic virus types of hand-foot-and-mouth disease（HFMD） in 2013-2017 in Heze to provide scientific evidence for the prevention and control and implementation strategy of the epidemic situation of HFMD in Heze.Methods Stool or specimens by means of a swab collected from regular medical organizations in every county and district of Heze from 2013 to 2017 were used to extract viral nucleic acid.Viral nucleic acid was tested using real-time fluorescence quantitative PCR.Epidemiological characteristics were analyzed using descriptive epidemiological method.Results 2751 specimens were collected from 2013 to 2017.Out of them,2294（83.39%） were positive.1111（40.39%） were EV71-positive.387（14.08%） were CA16-positive.796（28.93%） were other-enterovirus positive.Dominant strain in 2013 and 2015 was EV71.Dominant strain in 2014 was CA16.Dominant strain in 2016 and 2017 was other enterovirus.The differences among subgroups of age,sex and season were significant（P〈0.05）.The distributions of HFMD virus types in every year were statistically different（P〈0.05）.Conclusion The most common HFMD virus type in Heze from 2013 to 2017 was EV71,followed by other enterovirus and CA16.EV71 was the main pathogen which caused severe cases.Before the high-occurrence season,the health education and prevention and control in nurseries and scattered children should be enhanced.The promotion of vaccines and vaccination in young children should be done previously.It is necessary to strengthen the monitoring of HFMD.

关 键 词：手足口病 实时荧光定量PCR 肠道病毒71型(EV71) 柯萨奇病毒A16型(CA16) 核酸 

分 类 号：R446.5[医药卫生—诊断学]