2014—2019年长沙市手足口病病原谱及流行病学特征分析  

Etiological and epidemiological characteristics of hand,foot and mouth disease in Changsha city in 2014—2019

作　　者：叶文[1] 欧新华[1] 肖姗[1] 李灵之[1] 裴瑞青[1] 扶会媛 黄政[1] YE Wen;OU Xin-hua;XIAO Shan;LI Ling-zhi;PEI Rui-qing;FU Hui-yuan;HUANG Zheng(Department of Microbiology,Changsha Center for Disease Control and Prevention,Changsha,Hunan 410004,China)

机构地区：[1]长沙市疾病预防控制中心微生物检验科,湖南长沙410004

出　　处：《中国病毒病杂志》2022年第2期133-137,共5页Chinese Journal of Viral Diseases

基　　金：湖南省卫生健康委科研计划课题(202112061212);长沙市卫生计生委2018年科研计划课题项目(基于二代测序技术的长沙地区重症手足口病病例病原谱研究)。

摘　　要：目的了解2014—2019年长沙市手足口病(hand,foot and mouth disease,HFMD)病原谱构成及流行病学特征,为做好手足口病防控工作提供参考依据。方法2014年1月至2019年12月长沙市手足口病临床诊断病例样本,使用实时荧光定量聚合酶链反应(real-time polymerase chain reaction,RT-PCR)方法检测标本中的病毒核酸。用Excel 2007软件分析统计结果。结果2014—2019年共收集样本3569份,手足口病核酸检测阳性样本2463份(阳性率69.01%)。进一步分型结果显示柯萨奇病毒(coxsackievirus,CV)A组16型(CVA16)阳性538份(阳性率15.07%),肠道病毒(enterovirus,EV)A组71型(EV-A71)阳性345份(阳性率9.67%),其他型别肠道病毒阳性1575份(阳性率44.13%),5例病例为CVA16和EV-A71共同感染(阳性率0.14%)。按照病例分类将手足口病样本分为散发轻症、散发重症和聚集性疫情三类,不同病例分类之间的核酸阳性检测结果差异有统计学意义(χ^(2)=146.36,P<0.01)。2014—2019年长沙市手足口病病例样本阳性率多在4—7月和9—11月达到高峰,CV-A16型全年阳性率呈现出隔年升高的周期性趋势,其中EV-A71型下降明显,其他肠道病毒型别有所增加。对于2019年出现的其他型别肠道病毒阳性率双高峰的情况,RT-PCR结果显示优势病原体为柯萨奇病毒A组6型(CVA6)。结论2014—2019年长沙市手足口病的主要致病病原体为CVA16和EV-A71,CVA6有逐渐上升的趋势。应在加强病原监测的同时关注病原谱的变化,掌握手足口病病原体的流行规律,从而更加有针对性地做好手足口病防控措施。Objective To understand the etiological and epidemiological characteristics of hand,foot and mouth disease(HFMD)in Changsha from 2014 to 2019,and to provide a reference for the prevention and control of HFMD.Methods A total of 3569 samples were collected from clinically confirmed HEMD cases during January 2014 and December 2019.Real-time polymerase chain reaction(RT-PCR)was used to identify the virus.Excel 2007 software was used for data analysis.Results Out of 3569 samples,2463 were positive for HFMD with the positive rate of 69.01%.Further analysis showed that 538(15.07%)and 345(9.67%)samples were positive for CVA16 and EV-A71 genotype,1575(44.13%)were positive for other types of enterovirus,and 5 samples were positive for both CV-A16 and EV-A71.According to the clinical manifestation,study cases were divided into sporadic mild cases,sporadic severe cases(including death)and clustering cases(including outbreak),the positive rates of HFMD varied significantly among cases in these groups(χ^(2)=146.36,P<0.01).The positive rate of HFMD peaked in April to July and September to November.The positive rate of CVA16 type showed a periodic trend of increasing every other year,the positive rate of EV-A71 type reduced significantly,while the positive rates of other enterovirus increased significantly.RT-PCR showed that CVA16 was the dominant pathogen contributing to HFMD double peaks in 2019.Conclusions The major pathogenic agents of HFMD in Changsha city during 2014 and 2019 are found to be CVA16 and EV-A71,and CVA6 is on the rise.Therefore,pathogen monitoring should be strengthened to capture the changes in dominant pathogens in order to formulate targeted prevention and control measures for HFMD.

关 键 词：手足口病 肠道病毒 肠道病毒A组71型 柯萨奇病毒 流行病学 时间分布 

分 类 号：R725.1[医药卫生—儿科]