广西2010-2018年手足口病流行病学及病原学特征分析  

Epidemiologic characteristics and pathogenic surveillance results of hand, foot and mouth disease in Guangxi, 2010-2018

作　　者：康宁[1] 居昱[1] 王静[1] 陈敏 张超 陈敏玫[1] KANG Ning;JU Yu;WANG Jing;CHEN Min;ZHANG Chao;CHEN Min-mei(Acute Infectious Disease Control and Prevention Institute,Guangxi Center for Disease Control and Prevention,Nanning,Guangxi 530028,China)

机构地区：[1]广西壮族自治区疾病预防控制中心急性传染病防制所,广西南宁530028

出　　处：《中国热带医学》2021年第10期927-931,938,共6页China Tropical Medicine

基　　金：广西自然科学基金项目(No.2017GXNSFAA198369);广西医疗卫生适宜技术开发与推广应用项目(No.S2018112)。

摘　　要：目的分析广西2010—2018年手足口病流行特征和病原学监测结果,为广西制定手足口病预防控制措施提供科学依据。方法采用描述流行病学方法,对来源于中国疾病预防控制信息系统2010—2018年广西报告的手足口病例信息进行统计分析;用实时荧光聚合酶链反应方法对肠道病毒进行血清分型。结果广西2010—2018年共报告手足口病例2 007 297例,年报告发病率范围为308.43/10万~709.87/10万;发病存在春夏季和秋季流行高峰,报告的重症、死亡病例主要出现在初夏流行季节。2010—2018年共对76 882份标本开展RT-PCR血清分型,肠道病毒阳性57 098份,阳性检出率为74.27%,其中EV-A71型17 066份(29.89%),CV-A16型13 673份(23.95%),非EV-A71/CVA16其他肠道病毒26 359份(46.16%)。EV-A71是2010、2012、2014年的优势流行株,非EV-A71/CV-A16其他肠道病毒是2013、2015、2017年的主要流行血清型,CV-A16是2011、2018年流行优势血清型,2016年EV-A71、CV-A16与非EV-A71/CV-A16其他肠道病毒在报告患者中所占比例相近。EV-A71在重症、死亡的实验室确诊病例中构成比分别为56.37%、92.93%,但其构成比出现下降趋势;而非EV-A71/CV-A16其他肠道病毒构成比呈上升态势。结论广西手足口病流行有明显季节性。流行模式、病原谱正在发生改变,EV-A71流行强度下降,但仍是导致病例死亡的优势病原体;非EV-A71/CV-A16其他肠道病毒流行强度增加,是近年重症病例的主要血清型;要关注、加强对非EV-A71/CVA16其他肠道的检测和分型。持续的病原学监测有助于掌握手足口病主要病原谱演化规律,是手足口病精准防控政策制定和相关疫苗研发应用的关键。Objective To explore the epidemiological characteristics and pathogenic surveillance results of hand, foot,and mouth disease(HFMD) in Guangxi in 2010-2018, and we provide science-based evidence for developing prevention and control measures and strategies.Methods We used the descriptive epidemiological method to analyze the cases of HFMD from an Internet-based system, National Surveillance System in 2010-2018. Real-time fluorescence quantitative polymerase chain reaction(RT-PCR) was used to detect the serotype of enterovirus(EV).Results A total of 2 007 297 cases of HFMD were reported from Guangxi in 2010-2018, the reported mortality rate of HFMD ranged from 308.43/105 to 709.87/105 in this period. The reported cases normally peaked in late spring or early summer, and autumn season;the severe and death cases were most common among those reported in early summer season. The positive rate of RT-PCR laboratory-identified case was74.27%(57 098/76 882). Among those lab identification, EV-A71, CV-A16 and other-enterovirus were accounted for 29.89%(17 066/57 098), 23.95%(13 673/57 098), and 46.16%(26 359/57 098) respectively. EV-A71 was the dominant stain of pandemic in 2010, 2012, 2014;non-EV-A71/CV-A16 was the dominant serotype in the outbreaks in 2013, 2015, and 2017;and CV-A16 was identified as the dominant serotype in 2011 and 2018. EV-A71, CV-A16 and non-EV-A71/CV-A16 have identified similar proportion of cases dynamics in 2016. EV-A71 was predominant in severe cases and deaths, the average proportion of lab-identified severe cases and deaths caused by EV-A71 was 56.37% and 92.93% respectively;however, the declining trend among those cases caused by EV-A71 serotype, as well as the increasing trend among cases caused by nonEV-A71/CV-A16 was observed in this period.Conclusion The seasonality characteristic was significant in the epidemic of hand, foot and mouth disease in Guangxi from 2010 to 2018. The epidemic pattern and the pathogens spectrums have been changing in this period. EV-A71 was predominate in severe ca

关 键 词：手足口病 流行病学特征 病原学监测 

分 类 号：R725.1[医药卫生—儿科]