江苏省两地手足口病/疱疹性咽峡炎相关肠道病毒外环境调查  

Investigation on the external environment prevalence of hand-foot-andmouth disease/herpes angina-associated enterovirus in two places in Jiangsu province

作　　者：艾静[1] 嵇红[1] 王欣烨 张雪峰[1] 刘文东[1] 霍翔[1] 鲍倡俊[1] 樊欢[1] AI Jing;JI Hong;WANG Xin-ye;ZHANG Xue-feng;LIU Wen-dong;HUO Xiang;BAO Chang-jun;FAN Huan(Jiangsu Provincial Center for Disease Control and Prevention,Nanjing,Jiangsu 210009,China;不详)

机构地区：[1]江苏省疾病预防控制中心急性传染病防制所,江苏南京210009 [2]昆山杜克大学全球健康研究所,江苏昆山215316

出　　处：《现代预防医学》2020年第10期1758-1761,共4页Modern Preventive Medicine

基　　金：重症手足口病后遗症队列随访及其病原演变的特征性研究(国家青年科学基金项目)(81402732);基于多源大数据的呼吸道传染病预测预警方法研究(江苏省青年医学人才项目)(QNRC2016542);深度学习算法在重点传染病预测预警中的应用研究(江苏省卫生健康委科研项目)(Z2019006)

摘　　要：目的调查儿童手足口病/疱疹性咽峡炎感染可能的外界环境原因,寻找肠道病毒在公共场所外环境存在和污染的证据,为优化防控工作提供依据。方法在2个手足口病高发地市对医院、社区游乐区环境表面涂抹采样,检测肠道病毒,并对阳性标本进行测序。结果医院环境肠道病毒总检出率为10.44%,其中独立接诊区域检出率47.50%,非独立接诊区10.37%,差异均有统计学意义;接诊区肠道病毒检出率较高的环境表面分别是护士分诊台(50.00%)、医生坐诊台(36.67%)、诊室门把手(30.00%)、候诊区地面(22.73%)、候诊椅(20.41%)、洗手设施(7.69%)等;三级医院的肠道病毒检出率最高(17.99%);社区内公共游乐区检出率为1.08%,分别在滑滑梯扶手、滑滑梯表面和游乐区座椅表面检出。阳性标本进一步测序得到CVA16、CVA6、CVA10、CVB54个型别。结论手足口病/疱疹性咽峡炎接诊医院和社区公共游乐场环境物品表面检出肠道病毒,在手足口病/疱疹性咽峡炎流行季节应加强环境消毒。社区是容易引起交叉感染的区域,应引起重视。Objective The aim of this study was to investigate the possible external environmental causes of the high incidence of hand-foot-mouth disease(HFMD)/herpetic angina in children,find evidence of the existence and pollution of enterovirus in the external environment of public places,so as to provide basis for the optimization of prevention and control work.Methods An external environment investigation was conducted for prevalence in two high epidemic cities.The environmental surfaces were smeared and sampled.Air aerosol samples were collected in community public recreation areas in addition to hospitals.All samples were detected for enterovirus,while positive samples were subjected to sequencing analysis.Results The positive rates of enterovirus in the hospital environment and community public recreation areas were 10.44%and 1.08%,respectively.Control rates were 47.50%and 10.37%in independent admission area and non-independent admission area,respectively.The above differences were both statistically significant.Among consultation areas,nurse triages(50.00%),doctors'consultation tables(36.67%),the door handles of the consultation rooms(30.00%),the floors of the waiting areas(22.73%),the waiting chairs(20.41%)and hand washing facilities(7.69%)had relatively high positive detection rates for enterovirus.The slide handrails,slide surfaces and seats in the public recreation areas were easy to be polluted.Positive samples were further sequenced,resulting four virus types of CVA16,CVA6,CVA10,and CVB5.Conclusion In the epidemic seasons of HFMD/herpetic angina,the hospital environment disinfection should be strengthened,especially in the consultation area.In addition,community public playgrounds were also high-risk areas of cross infection required for more attention.

关 键 词：手足口病 疱疹性咽峡炎 肠道病毒 外环境 

分 类 号：R126[医药卫生—环境卫生学]