2019-2022年深圳市南山区手足口病流行情况及病原学特征分析  

The Epidemic and etiological characteristics of hand-foot-mouth disease in Nanshan District of Shenzhen City from 2019 to 2022

作　　者：马艳萍 陈辉[1] 马佳智 胡春明[2] 阮嘉雯 王颖[1] 段永翔[1] 俞慕华[1] 鞠长燕[1] Ma Yanping;Chen Hui;Ma Jiazhi;Hu Chunming;Ruan Jiawen;Wang Ying;Duan Yongxiang;Yu Muhua;Ju Changyan(Shenzhen Nanshan Center for Disease Control and Prevention,Shenzhen 518054,China;Department of Preventive Health Care,Shenzhen Overseas Chinese Town Hospital,Shenzhen 518053,China)

机构地区：[1]深圳市南山区疾病预防控制中心,深圳518054 [2]深圳华侨城医院预防保健科,深圳518053

出　　处：《中华检验医学杂志》2024年第9期1073-1078,共6页Chinese Journal of Laboratory Medicine

基　　金：深圳市南山区科技计划(2021111);深圳市南山区重点学科建设。

摘　　要：目的了解2019—2022年深圳市南山区手足口病(HFMD)流行情况及病原学特征,为辖区内的HFMD防范提供科学依据。方法利用描述性研究方法对中国疾病预防控制信息系统中深圳市南山区2019—2022年HFMD流行病学数据进行分析。应用多重荧光PCR方法对临床诊断HFMD样本进行病原学特征分析,对优势病原柯萨奇病毒A组6型(CV-A6)的VP1基因进行扩增和测序,用DNASTAR软件的SepMan Pro进行序列拼接及MegAlign进行核苷酸同源性分析,用MEGA 6软件构建系统发育树,应用SPSS22.0进行统计学分析。结果2019—2022年深圳市南山区累计报告HFMD病例13195例,年均发病率为186.18/10万,夏秋季为主要发病季节,7岁以下儿童为主要发病人群,占比93.1%(12278/13195),男女性别比为1.44∶1。实验室检测临床诊断HFMD样本451份,其中阳性样本403份,阴性样本48份,病原构成主要为CV-A6(63.03%,254/403),柯萨奇病毒A组16型(CV-A16)(27.79%,112/403)、柯萨奇病毒A组4型(CV-A4)(4.71%,19/403)、柯萨奇病毒A组10型(CV-A10)(1.99%,8/403)、埃可病毒11型(Echo-11)(0.25%,1/403)、不确定型别占2.23%(9/403),未检出肠道病毒71型(EV71)。13株毒株核苷酸同源性94.0%~99.6%,与原型株Gdula核苷酸同源性84.1%~85.8%。系统发育树结果显示南山区13株CV-A6毒株均为D3a基因型,为中国内地优势流行型别。结论2019—2022年深圳市南山区HFMD呈现明显的人群和时间分布差异,应加强夏秋季节及重点人群HFMD防控宣传教育。CV-A6和CV-A16为近年来深圳市南山区HFMD优势毒株,应加强对优势毒株的监测。Objective To understand the epidemiological and etiological characteristics of hand-foot-mouth disease(HFMD)in the Nanshan District of Shenzhen City from 2019 to 2022 and to provide a scientific basis for HFMD prevention in the area.Methods Epidemiological data on HFMD in Shenzhen Nanshan District from 2019 to 2022 in the China Information System for Disease Control and Prevention were analyzed using descriptive research methods.Real-time reverse transcription polymerase chain reaction(RT-PCR)was used to analyze the etiology characteristics of clinical specimens from HFMD patients.The VP1 gene of the dominant pathogen coxsackievirus A6(CV-A6)was amplified and sequenced.SepMan Pro of DNASTAR software was used for sequence assembly and MegAlign was used for nucleotide homology analysis.Results A total of 13195 HFMD cases were reported in Shenzhen Nanshan District from 2019 to 2022,with an average annual incidence rate of 186.18/100,000.Summer and autumn are the main onset seasons and children under 7 years old were the main population,accounting for 93.1%.The male-to-female ratio is 1.44∶1.A total of 451 clinical HFMD specimens were detected in the laboratory,including 403 positive(87.36%)and 48 negative(10.64%).The main pathogens were CV-A6(63.03%),coxsackievirus A16(CV-A16)(27.79%),coxsackievirus A4(CV-A4)(4.71%),coxsackievirus A10(CV-A10)(1.99%),Echovirus 11(Echo-11)(0.25%),and uncertain type accounted for 2.23%,with no detection for enterovirus71(EV71)type.The nucleotide homology of the 13 CV-A6 strains ranged from 94.0%‒99.6%,and the nucleotide homology with the prototype strain Gdula ranged 84.1%‒85.8%.The results of phylogenetic tree showed that all 13 CV-A6 strains in Nanshan District were of the D3a genotype.Conclusions FHFMD in Nanshan District of Shenzhen City in 2019-2022 shows obvious differences in population and time distribution.Therefore,it is necessary to strengthen publicity and education on HFMD prevention and control in the summer and fall seasons and among key populations.CV-A6 and CV-A1

关 键 词：手足口病 流行病学 病原 

分 类 号：R725.1[医药卫生—儿科]