2016—2019年手足口病病原体流行病学特征分析  

Analysis of the epidemiologic characteristics and detection of the pathogens in children with hand,foot and mouth disease during 2016-2019

作　　者：胡海贇 蔡明毅 葛玮[1] Hu Haiyun;Cai Mingyi;Ge Wei(Shanghai Children’s Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200040,China;Jing’an District Center for Disease Control and Prevention of Shanghai,Shanghai 200040,China)

机构地区：[1]上海市儿童医院上海交通大学附属儿童医院,200040 [2]上海市静安区疾病控制中心,200040

出　　处：《中华实验和临床病毒学杂志》2021年第3期291-295,共5页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的了解手足口病不同病原体的感染现状以及流行病学特点,为制定观察、治疗方案,做好手足口病防控工作提供参考。方法收集2016年1月至2019年12月在上海市儿童医院院传染科门诊诊断为手足口病的病例采集部分病例的咽拭子、粪便标本进行病原学检测并收集相关资料进行流行病学分析。用RT-PCR法对肠道病毒71型(enterovirus 71,EV-A71)、柯萨奇病毒A组16型(coxsackievirus A 16,CV-A16)、柯萨奇病毒A组6型(CV-A6)、柯萨奇病毒A组10型(CV-A10)、肠道病毒通用型(PE)进行鉴别。结果共采集522份标本,472份标本呈现病毒阳性,检出阳性率为90.4%;CV-A6的检出率最高为52.5%(274/522)、其次是CV-A16为23%(120/522)、第三位为EV-A71为10.5%(55/522)、第四位CV-A10为2.3%(12/522)。4种病毒4年的检出率差异均有统计学意义(P=0.00;P=0.00;P=0.00;P=0.03);CV-A6病毒感染组男女性别差异有统计学意义(P=0.007),男患儿的感染率高于女患儿;CV-A6在0~1岁年龄组感染率最高;EV-A71在幼托/学生中感染率要高于散居儿童(P=0.044),CV-A6在散居儿童中感染占比较高(P=0.009);CV-A16和其他肠道病毒在郊区和外省的感染占比较高(P=0.05;0.031);EV71和CV-A16在春夏季感染率较高(P<0.001),CV-A6在秋冬季感染率明显高(P<0.001);CV-A6的感染构成比4年平均在50%以上;EV-A71在2016—2017年存在20%左右的感染构成比,2018—2019年明显减少,仅有0%~3.3%。结论手足口病病原体呈现交替流行;对手足口病病原体流行病学特征的分析比较有助于对疾病的防控、早期治疗、重症病例的筛查。Objective To investigate the current epidemic situation of etiological agents,analyze the characteristics’differences in children with hand,foot and mouth disease and to provide relevant data for observing,treating,and preventing hand,foot and mouth disease.Methods Epidemiological analysis on the cases diagnosed of hand,foot and mouth disease from January 2016 to December 2019 in our clinic service.Collected specimens included stool and throat swabs to detect the pathogens.The specimens were tested by RT-PCR assay with enterovirus consensus primer and specific primer for enterovirus 71(EV71)and coxsackievirus A16(CV-A16)and so on,respectively.Results Totally 522 specimens were collected,the overall positive rate was 90.4%;CV-A6 infection was mainly popular in four years.The epidemic characteristics of enterovirus infection within 2016-2019 had significant differences(P=0.00);the second one was CoxA16,the third one was Ev71,the fourth one was CV-A10,these four types of enterovirus within 2016-2019 had significant differences(P<0.001;P<0.001;p=0.03);the ratio of sex and age-group had significant difference in CV-A6 group(P=0.007);the endemic distribution had significant difference(P<0.05);EV71 and CV-A16 approximately emerged from spring to summer(P<0.001);CV-A6 was at the most prevalent position,the prevelant seasons were autumn and winter(P<0.001).Conclusions HFMD showed alternant epidemic characteristics at different times of enterovirus infection.Analyzing the differences of epidemiologic characteristics of enterovirus infection is helpful to prevent and control enterovirus infection,and also is useful for early identification of severe cases and handling the outbreaks.

关 键 词：手足口病 肠道病毒 流行病学 

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