摘要
目的分析铜仁市2015-2020年手足口病病原分布特征,为手足口病的防控工作提供科学依据。方法收集2015-2020年铜仁市各区(县)手足口病临床诊断病例咽拭子3726份,采用实时荧光定量反转录-聚合酶链反应进行肠道病毒(EV)通用型核酸检测,对EV通用型阳性的标本进行EV71、柯萨奇病毒A组16型(CoxA16)、CoxA10和CoxA6亚型核酸检测。结果3726例病例中,肠道病毒核酸检测阳性率为43.72%,CoxA6、CoxA10、CoxA16、EV71和其他EV分别为16.21%、3.56%、20.93%、16.45%、43.03%。不同年份、地区、年龄、月份、病例类型肠道病毒核酸检测阳性率差异有统计学意义(χ^(2)=95.352、224.171、18.394、121.501,P均<0.001)。2020年病毒核酸阳性率最高为56.10%(193/344),松桃县阳性率最高为60.00%(243/405),1~<4岁年龄组占总阳性数70.04%(1141/1629)。全年均有发病,4-6月为发病高峰期,占总阳性数40.70%。不同病例类型肠道病毒核酸阳性检出率差异有统计学意义(χ^(2)=46.869,P<0.001),呈现死亡病例>重症病例>普通病例。不同年份、地区、年龄、月份、病例类型各型别优势毒株不同(P均<0.05),2015-2017年主要以其他EV为主,2018-2020年以CoxA6为主。玉屏县以CoxA16(39.22%)为主,其余各区(县)均以其他EV为主。0~<4岁年龄组以其他EV为主,4~<5岁年龄组以CoxA16为主,5~<6岁和6岁以上年龄组以EV71为主。5-6月份以EV71为主,其余月份均以其他EV为主。普通型、重型以其他EV为主,死亡病例均为EV71。结论铜仁市手足口病病原为多种型别共存,不同年份、地区、月份、年龄、病例类型流行优势株不一样,应加强肠道病毒的病原监测,及时掌握地区内手足口病病原分布及变异情况,有利于手足口病疫情研判和防控策略的制定。
Objective To analyze the distribution characteristics of hand-foot-mouth disease(HFMD)pathogens in Tongren from 2015 to 2020,and provide scientific basis for the prevention and control of HFMD.Methods Pharyngeal swabs were collected from clinically diagnosed cases of HFMD in all counties and districts of Tongren city from 2010 to 2018.Real-time fluorescence quantitative PCR was used for detection of the HFMD pathogens.Results In 3726 cases,the positive rate of enterovirus nucleic acid detection was 43.72%,and the rates of CoxA6,CoxA10,CoxA16,EV71 and other EVs were16.21%,3.56%,20.93%,16.45%and 43.03%,respectively.The positive rate of Enterovirus nucleic acid detection was different in different years,regions,ages,months and case types(χ^(2)=95.352,224.171,18.394,121.501,all P<0.001).The highest positive rate was 56.10%(193/334)in 2020,and the highest positive rate was 60.00%(243/405)in Songtao county.The age group of 1-<4 years old accounted for 70.04%of the total positive cases,and the incidence occurred throughout the year.The peak of the incidence was from April to June,accounting for 40.70%of the total positive cases.The positive rate of different case types showed death cases>severe cases>common cases.The dominant strains were different in different years,regions,ages,months and case types(P<0.05).The dominant strains were other EV groups from 2015 to 2017,and CoxA6 was the dominant strain from 2018 to 2020.CoxA16(39.22%)was dominant in Yuping county,and other EV groups were the dominant group in other districts(counties).The majority of EVs were found in the 0-<4 years old;CoxA16 in the 4-<5 years old group,and EV71 in the 5-<6 and 6 years old and above groups.EV71 was dominant in May and June,and other EVs in the rest months.The common type and severe type were mainly other EVs,and the death cases were EV71.Conclusions The pathogens of HFMD coexist in Tongren,and the dominant virus strains were different in different years,regions,months,ages and case types.Therefore,the pathogen monitoring of Enterovirus
作者
张平
任达飞
高前荣
李建华
郑佳敏
ZHANG Ping;REN Da-fei;GAO Qian-rong;LI Jian-hua;ZHENG Jia-min(Tongren Center for Disease Control and Prevention,Tongren,Guizhou 564300,China;School of Public Health,Guizhou Medical University,Guiyang,Guizhou 550025,China)
出处
《热带医学杂志》
CAS
2022年第10期1435-1440,共6页
Journal of Tropical Medicine
基金
中央补助资金手足口监测项目(黔卫健函【2020】144号)
关键词
手足口病
肠道病毒
病原学
Hand-foot-mouth disease
Enterovirus
Etiology
