2009-2021年全国5岁以下儿童发热伴出疹症候群病原构成及流行特征分析  

Analysis on etiological and epidemiological characteristics of rash and fever syndrome in children aged<5 years in China,2009-2021

作　　者：林帆 郭玉清 李开明 吴彦霖 李柏松 郑亚明[1] 崔爱利[3] 王丽萍[1] Lin Fan;Guo Yuqing;Li Kaiming;Wu Yanlin;Li Bosong;Zheng Yaming;Cui Aili;Wang Liping(National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases,Division of Infectious Disease,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Chongqing Center for Disease Control and Prevention,Chongqing 400042,China;National Institute for Viral Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing102206,China)

机构地区：[1]中国疾病预防控制中心传染病管理处,传染病溯源预警与智能决策全国重点实验室,北京102206 [2]重庆市疾病预防控制中心,重庆400042 [3]中国疾病预防控制中心病毒病预防控制所,北京102206

出　　处：《疾病监测》2024年第6期681-687,共7页Disease Surveillance

基　　金：国家科技重大专项(No.2018ZX10713001);公共卫生应急反应机制运行项目(No.102393220020010000017)。

摘　　要：目的了解我国5岁以下儿童发热伴出疹症候群(RFS)的病原构成及流行特征,为儿童出疹性传染病的诊疗和和科学防控提供参考。方法基于国家传染病监测技术平台RFS监测数据,监测病原包括肠道病毒、麻疹病毒、风疹病毒、水痘–带状疱疹病毒、登革病毒、人细小病毒B19、埃博拉病毒、寨卡病毒、人疱疹病毒6型、EB病毒、A组链球菌、伤寒、副伤寒沙门菌、伯氏疏螺旋体和立克次体。采用描述性流行病学方法分析2009—2021年全国5岁以下儿童RFS病原构成及流行特征。结果我国5岁以下儿童RFS患者以病毒感染为主,主要是肠道病毒(85.78%)、麻疹病毒(10.03%)和水痘-带状疱疹病毒(1.45%),合计占比为97.26%,风疹病毒等其余病原在2018—2021年占比有所增加。2009—2021年肠道病毒优势血清型从肠道病毒A组71型(EV-A71)和柯萨奇病毒A组16型(CV-A16)转换为柯萨奇病毒A组6型(CV-A6)和柯萨奇病毒A组10型(CV-A10)。RFS总体病原检出率在1~2岁年龄组(70.53%)高于其他年龄组(χ2=292.336,P<0.001),南方地区(71.12%)高于北方地区(65.35%)(χ2=305.946,P<0.001);肠道病毒在1~2岁年龄组患儿、南方地区检出率较高,麻疹病毒在<1岁患儿、北方地区检出率较高,水痘–带状疱疹病毒在北方地区检出率较高。RFS总体病原在春夏季检出率高于秋冬季(χ2=295.060,P<0.001),其中肠道病毒夏秋季高发,麻疹病毒冬春季高发,水痘–带状疱疹病毒冬季高发,3种病毒南、北方地区季节性分布峰有所差异。结论2009—2021年全国5岁以下儿童RFS患儿以病毒感染为主,尤其以肠道病毒、麻疹病毒和水痘–带状疱疹病毒感染较为常见,RFS患儿病原体感染呈现多样化趋势,肠道病毒优势血清型发生转变,应持续加强对儿童RFS病原谱的监测。Objective To understand the etiological and the epidemiological characteristics of rash and fever syndrome(RFS)in children aged<5 years in China,and provide evidence for the diagnosis,prevention and control of RFS.Methods Based on the data of RFS from National Infectious Disease Surveillance Platform,the pathogens included enterovirus,measles virus,rubella virus,varicella-zoster virus,dengue virus,human parvovirus virus B19,Ebola virus,zika virus,human herpesvirus 6,Epstein-Barr virus,streptococcus group A,Salmonella typhi and Salmonella paratyphoid,borrelia�burgdorferi and rickettsia.The descriptive analysis was used to analyze the compositions of pathogens and the epidemiological characteristics of RFS in children aged<5 years in China from 2009 to 2021.Results RFS in the children was mainly caused by viruses,which included enterovirus(85.78%),measles virus(10.03%)and varicella-zoster virus(1.45%),causing 97.26%of the total RFS cases.The cases caused by rubella virus and other pathogens increased from 2018 to 2021.The predominant enterovirus serotypes shifted from EV-A71 and CV-A16 to CV-A6 and CV-A10 during 2009-2021.The highest detection rate of RFS was reported in age group 1-2 years(70.53%)(χ2=292.336,P<0.001)and the detection rate was higher in southern China(71.12%)than in northern China(65.35%)(χ2=305.946,P<0.001).The positive rate of enterovirus was higher in age group 1-2 years and in southern China.The positive rate of measles virus was higher in age group<1 years in northern China.The positive rate of varicella-zoster virus was higher in northern China.The positive rate in spring and summer was higher than that in autumn and winter(χ2=295.060,P<0.001).The positive rate of enterovirus increased in summer and autumn,while the positive rate of measles virus increased in winter and spring,and the positive rate of varicella-zoster virus was highest in winter.The seasonal distribution detection peaks of the three viruses were different in the south and north regions.Conclusion Viruses,especially enter

关 键 词：发热伴出疹症候群 5岁以下儿童 病原学和流行病学特征 

分 类 号：R211[医药卫生—中医学] R183.1