2013-2017年无锡市手足口病流行病和病原学特征分析  

Study of epidemiological and pathogenic characteristics of hand-foot-and-mouth disease in Wuxi city from 2013 to 2017

作　　者：石平[1] 陈欲晓[2] 高雨蒙 沈元[1] 施超[1] 吴莹[3] SHI Ping;CHEN Yu-xiao;GAO Yu-meng;SHEN Yuan;SHI Chao;WU Ying(Wuxi Center for Disease Control and Prevention,Wuxi Jiangsu 214023,China)

机构地区：[1]无锡市疾病预防控制中心，江苏无锡214023 [2]南京医科大学附属无锡市儿童医院，江苏无锡214023 [3]江苏省疾病预防控制中心，江苏南京210009

出　　处：《现代预防医学》2019年第8期1498-1502,共5页Modern Preventive Medicine

基　　金：无锡市"科教强卫工程"项目医学重点学科(No.ZDXK009);医学重点人才(No.ZDRC003);医学青年人才(No.QNRC008);无锡市科技发展项目(CSE31N1515);江南大学公共卫生研究中心项目(JUPH201847)

摘　　要：目的了解无锡市2013-2017年手足口病(HFMD)流行病学及病原学变化特征,为本地区HFMD防控提供科学依据。方法利用2013-2017年疾病监测信息系统报告的HFMD病例进行描述性流行病学分析。同时收集无锡市哨点医院HFMD病例的粪便样本,采用肠道病毒通用(EV)、肠道病毒71型(EV71)和柯萨基病毒A组16型(CA16)荧光定量检测试剂盒进行核酸检测和测序分析。结果无锡市2013-2017年共报告HFMD 82 132例,年均发病率249.32/10万。病例报告以1～3岁发病率最高,且以散童(53.72%)为主。全年有5-7月和11-12月2个发病高峰,重症发生集中在7-8月。2013-2017年病原学监测结果显示,普通病例以EV71(46.08%)和CA16(35.78%)为主,重症病例以EV71(86.45%)为主(P<0.001)。2012-2016年其他肠道病毒以CB5为主,占72.50%;2017年其它肠道病毒以CA6为主,占90.00%。结论无锡市HFMD的发生存在周期性和季节性,呈现每隔1～2年出现1次流行高峰的特点;居住在城乡结合部地区的1～3岁儿童是HFMD的重点防控人群;2017年其他肠道病毒优势株由CB5转为CA6,CA6可能成为继CA16、EV71的另一个其他肠道病毒优势株。Objective The aim of this study was to explore the epidemiological and pathogenic characteristics of the handfoot-and-mouth disease(HFMD) in Wuxi city, and to provide evidence for prevention and control of the disease. Methods Information of the cases was collected through the Chinese national HFMD surveillance system from 2013 to 2017, and analyzed by descriptive epidemiological methods. Meanwhile, stool samples of HFMD cases were collected from sentinel hospitals for viral nucleic acid detection. Those strains of non-Enterovirus 71 and non-CA16 were sequenced and analyzed by VP1, and then the type of strains was identified by BLAST program. Results 82132 cases of HFMD were reported in Wuxi from 2013 to 2017 and the average annual incidence was 249.32/100000. The incidence rate was the highest in the age group of 1-3 years old and 53.72% of the patients were children at home. There were two seasonal peaks in May-July(spring and summer peak) and November-December(winter peak). The incidence of severe HFMD was highest in July and August. The EV71(46.08%) and CA16(35.78%) were major pathogens for HFMD in Wuxi from 2013 to 2017. EV71(86.45%)accounted for most of the severe cases. CB5 was the main strain of other enteroviruses from 2012 to 2016, accounting for 72.5%,while CA6 in 2017, accounted for 90.0%. Conclusion The incidence of HFMD in Wuxi was periodic with seasonal distribution. It presented the characteristics of one peak every 1 to 2 years. Children aged 1-3 living in urban and rural areas were the key population for HFMD prevention and control. In 2017, the other enterovirus dominant strains changed from CB5 to CA6, and CA6 may become another predominant enterovirus strain following CA16 and EV71.

关 键 词：HFMD 流行特征 重症病例 病原学特征 基因特征 

分 类 号：R183[医药卫生—流行病学]