目的 了解滁州市手足口病流行病特征和病原学构成情况,为手足口病防控策略及预警提供科学依据。方法 采集手足口病临床诊断病例咽或肛拭子标本,采用Real-time PCR方法对标本进行肠道病毒(EV)核酸检测,分析手足口病病原学特点。结果 2018—2019年共收集手足口病样本885份,EV核酸阳性检出率72.88%(645/885),柯萨奇病毒16型(CVA16)、肠道病毒71型(EV71)和其他EV构成比分别为35.35%、3.57%和61.08%。2018年优势病毒型别以其他EV为主,2019年优势病毒型别是CVA16和其他EV;EV检出率出现两个高峰,4—6月阳性标本最多,占55.04%(355/645);不同县区EV阳性检出率有统计学意义(χ2=74.512,P<0.001),琅琊区最高(89.58%、86/96),来安县最低(46.74%、43/92);0~4岁幼儿EV阳性标本最多,为73.59%(574/780)。肛拭子阳性检出率在0~岁年龄组最高,阳性检出率为95.45%(21/22);EV阳性标本主要集中在发病后1~5 d,发病后3 d阳性检出率最高。结论 滁州市手足口病优势病原类型发生变化,检出率受多种因素影响,应加强标本质量控制,扩大肠道病毒监测范围。
Abstract
Objective To understand the epidemiological characteristics and etiological composition of hand-foot-and-mouth disease (HFMD) in Chuzhou City,so as to provide scientific basis for control strategy and early warning of HFMD. Methods The throat or anal swab samples from clinically diagnosed cases of HFMD were collected.The enterovirus were detected by Real-time PCR (qPCR).Then the pathogenic characteristics of HFMD were analyzed in the last two years. Results A total of 885 HFMD samples were collected from 2018 to 2019,with the positive rate of EV nucleic acid of 72.88% (645/885).The composition ratios of CVA16,EV71 and other EVs were 35.35%,3.57% and 61.08% respectively.The dominant virus types were mainly other EVs in 2018 and CVA16 and other EVs in 2019.There were two peaks in positive rate of EV,with the most positive samples from April to June,accounting for 55.04% (355/645).The positive detection rate of EV was statistically significant in different counties (χ2=74.512,P<0.001).The highest and lowest positive rates were in Langya district (89.58%,86/96) and Lai'an county (46.74%,43/92) respectively.Children aged 0~4 years old had the most EV positive samples,accounting for 73.59% (574/780).The highest positive rate of anal swabs was in the 0 year-old age group (95.45%,21/22).Positive EV specimens were mainly concentrated in the first to fifth days after the onset of disease,with the highest positive detection rate on the third day after the onset of disease. Conclusion The dominant pathogen types of HFMD in Chuzhou City had changed from 2018 to 2019,and the positive rate was affected by many factors.It is necessary to strengthen the quality control of samples and expand the scope of enterovirus monitoring.
关键词
手足口病 /
肠道病毒 /
病原学
Key words
Hand-foot-and-mouth disease /
Enterovirus /
Etiology
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