2018—2020年江苏省苏州市疱疹性咽峡炎病例分析  

Herpangina cases of Suzhou,2018-2020

作　　者：许倩 张萍 杭惠 崔朋伟[1] 谭亚运[1] 陈立凌[1] XU Qian;ZHANG Pin;HANG Hui;CUI Peng-wei;TAN Ya-yun;CHEN li-ling(Suzhou Municipal Center for Disease Control and Prevention,Suzhou,Jiangsu 251000,China)

机构地区：[1]苏州市疾病预防控制中心,江苏215000

出　　处：《现代预防医学》2021年第3期538-541,共4页Modern Preventive Medicine

基　　金：苏州市姑苏卫生人才培养项目(GSWS2019024);苏州市医学重点学科(Szxk201516);基于医疗健康大数据的传染病监测与预警关键技术研究(SS202073)。

摘　　要：目的分析苏州市2018—2020年疱疹性咽峡炎的流行特征和病原学的分布及变化趋势,为疱疹性咽峡炎的防控提供科学依据。方法收集在苏州监测医院就诊的疱疹性咽峡炎病例的基本信息和病原学信息。采用实时荧光-PCR方法进行病毒核酸检测,并对结果信息进行描述分析。结果 2018年5月至2020年6月共采集疱疹性咽峡炎病例标本1 092例,监测期内无重症和死亡病例,标本阳性率为48%(529/1 092),主要病原类型为CoxA6(34.03%),Cox A16(20.60%),其他肠道病毒(44.42%);阳性标本中,≤6岁儿童占95.7%,男性标本阳性率稍高于女性;6-9月标本阳性率较高,3月最低,不同月份阳性率差异有统计学意义。监测期内,共发生疱疹性咽峡炎聚集性疫情19起(2020年0起),总发病人数113,发病高峰期集中在每年的4-6月和9-11月,以3、4岁学龄儿童为主;2018和2019年疫情的主要病原分别为CoxA6和EV71。结论苏州疱疹性咽峡炎的易感人群是≤6岁以下的儿童,好发于夏秋季,主要的致病原为CoxA6、CoxA16和其他肠道病毒。疱疹性咽峡炎的主要病原体和手足口病相同,且优势毒株不断转变,应加强监测,建议依照手足口病的管理办法进行防控。Objective To analyze the epidemiological characteristics and etiology of herpangina in Suzhou from 2018 to 2020 to provide evidence for its prevention and control. Methods The demographic information and specimen of patients’ with herpangina treated in Suzhou from 2018 to 2020 were collected. The real-time fluorescence-PCR was used to detect the virus nucleic acid. Results A total of 109 2 specimens of patients with herpangina were collected in Suzhou from May 2018 to June 2020. The positive rate of the specimens was 48%, and no cases of severe illness or death were detected. The main pathogen was CoxA6(34.0%), CoxA16(20.6%) and other enterovirus(44.4%) in the positive specimens. Children ≤6 accounted for 95.7% and the positive rate of male specimens was slightly higher than that of female among positive specimens. The positive rate of June, August and September were higher than other months, and the positive rate of March was the lowest, with statistically significant differences between different months. There were 19 herpangina clusters and a total of 113 patients in Suzhou during the monitoring period. There was no herpangina cluster from Januray to June in 2020. The peak of the clusters was April to June and September to November and mainly in children aged 3 and 4. The main pathogen of the herpangina cluster was CoxA6 in 2018 and other enterovirus in 2019. Conclusion The susceptible population of the herpangina is children≤6 years, and the epidemic peak was summer and autumn, the main pathogen was CoxA6, CoxA16 and other enterovirus. Herpangina and hand-foot-mouth disease(HFMD) have same main pathogen involved EV71, CoxA6 and CoxA16. The dominant virus of herpangina was changing. Therefore, it is suggested to strength the monitoring and the management of herpangina referring to HFMD.

关 键 词：疱疹性咽峡炎 流行学特征 手足口 病原学特征 

分 类 号：R725.1[医药卫生—儿科] R181.3[医药卫生—临床医学]