2013~2018年泰安地区手足口病病原学构成及流行病学分析  

Etiological and Epidemiological Analysis of Hand,Foot,and Mouth Disease in Taian,China,2013-2018

作　　者：吕静 魏希文[1] 阴珊珊[1] 张荣强[1] 倪楠[1] 张爱华[1] 杨会利[1] 侯佩强[1] LYU Jing;WEI Xiwen;YIN Shanshan;ZHANG Rongqiang;NI Nan;ZHANG Aihua;YANG Huili;HOU Peiqiang(Taian Center for Disease Control and Prevention,Taian 271000,China)

机构地区：[1]泰安市疾病预防控制中心,泰安271000

出　　处：《病毒学报》2020年第6期1037-1042,共6页Chinese Journal of Virology

基　　金：泰安市科技发展项目(项目号:2016NS1202),题目:手足口病毒气源性传染的研究;泰安市科技发展项目(项目号:201340629),题目:利用斑点杂交检测手足口病病毒新技术方法的建立与应用;山东省医药卫生科技发展计划(项目号:2019WS205),题目:山东省泰安市儿童病毒性腹泻的流行特征及基因特征分析。

摘　　要：近年来手足口病(Hand,foot,and mouth disease,HFMD)对我国儿童的健康造成了严重的危害。为了解山东省泰安地区HFMD的感染状况,本研究对2013~2018年度3043份HFMD标本,应用实时荧光定量PCR进行肠道病毒A组71型(Enterovirus A71,EV-A71)、柯萨奇病毒A组16型(Coxsachievirus A16,CV-A16)和其他肠道病毒(其他EV)的病原体检测和分析。结果显示,肠道病毒检出阳性率为86.82%,确诊病例中其他EV所占比例最高,为42.92%,EV-A71和CV-A16分别占30.62%和26.46%。EV-A71是引起重症HFMD的主要病原,占73.09%。2013~2016年EV-A71和CV-A16为优势病原,占比例达50%以上,在2014年和2016年出现两个增长高峰。其他肠道病毒与EV-A71、CV-A16出现交替流行状况,2017年所占比例达到54.27%,2018年继续上升至77.78%。本地区HFMD夏季高发,集中在5~8月份,1~4岁幼儿易感,占确诊病例总人数的82.95%,特别是1~2岁年龄段发病比例较高,男女感染性别比为1.52∶1。2017~2018年其他肠道病毒成为优势病原,且引起重症病例数增加,重视其监测工作对婴幼儿HFMD的预防控制及疫苗研制具有重要指导意义。In recent years,hand,foot,and mouth disease(HFMD)has caused serious harm to children’s health in China.To investigate the epidemiological and pathogenic characteristics of HFMD in Taian City,Shandong Province,China,we collected 3,043 samples of laboratory surveillance HFMD cases from 2013 to2018.Enterovirus 71(EV-A71),coxsackievirus A16(CV-A16)and other enterovirus(EV)were detected and analyzed by real-time PCR.The EV-positive rate was 86.82%of total cases,and the proportion for other EV was 42.92%of all laboratory-confirmed HFMD cases,which was higher than EV-A71(30.62%)and CVA16(26.46%).But EV-A71 was predominantly associated with severe HFMD with proportion of 73.09%.EV-A71 and CV-A16 predominated from 2013 to 2016 with proportion more than 50%and presented as two large peaks in 2014 and 2016.Other EV was alternately as the predominant pathogen during the little peaks of EVA71 and CV-A16,accounting for 54.27%of all laboratory-confirmed cases in 2017 and rising to 77.78%in2018.The incidence of HFMD in this area was high in summer,concentrated from May to August.Children aged 1-4 years were susceptible,accounting for 82.95%of all laboratory-confirmed cases,especially the 1-2 years old with higher proportion.The ratio of male to female infection was 1.52.From 2017 to 2018,other EV became the dominant pathogen and caused an increase of severe cases.It is of great significance to pay attention to monitoring other EV for the prevention and control of HFMD and the development of vaccine for infants.

关 键 词：手足口病(HFMD) 肠道病毒 病原学 流行病学 

分 类 号：R373.2[医药卫生—病原生物学]