宁夏回族自治区2009～2017年手足口病流行病学特征及病原学监测分析
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摘要
手足口病(Hand,foot and mouth disease,HFMD)是一种儿童常见的自限性传染病,但部分病例会发展成重症,甚至导致死亡。为分析2009～2017年宁夏回族自治区HFMD流行病学和病原学特征,本研究采用描述流行病学方法对2009～2017年HFMD监测资料和病原学结果进行统计分析,采用real-time PCR方法对采集的HFMD患者标本进行肠道病毒A组71型(Enterovirus A71,EV-A71)、柯萨奇病毒A组16型(Coxsachievirus A16,CV-A16)和其它肠道病毒(Enterovirus,EV)进行核酸检测。2009～2017年宁夏回族自治区累计报告HFMD病例59 281例,重症病例191例,死亡13例,年均发病率为102.13/10万,银川市和吴忠市发病率高于其他地区。发病主要集中在5～7月份,占全年病例总数的58.44%,男女比例为1.52∶1,0～4岁儿童占82.48%。实验室确诊病例6 832例,其中CV-A16占36.85%、EV-A71占32.63%、其他EV占30.52%。重症病例病原主要以EV-A71为主(占77.49%)。EV-A71、CV-A16和其他EV呈现交替为优势病原的流行规律。宁夏回族自治区HFMD流行具有明显的季节性、地区性和人群性,5岁以下儿童仍然是防控的重点。在做好EV-A71和CV-A16监测的同时,应重视其他EV的监测工作,及时掌握HFMD病原谱的变化。
Hand,foot and mouth disease(HFMD) is one kind of self-limited infectious disease and very common in children. However, a few cases will become severe ones, even deaths. To analyze the epidemiological and pathogenic characteristics of hand,foot and mouth disease(HFMD) in Ningxia Hui Autonomous Region,China,from 2009 to 2017,the descriptive epidemiological methods were used to analyze surveillance data and etiological results from 2009 to 2017. Real-time polymerase chain reaction(PCR)was employed to detect enterovirus A71(EV-A71),coxsackievirus A16(CV-A16)and other enterovirus(EV)from collected specimens. From 2009 to 2017,59,281 cases,191 severe cases and 13 deaths were reported. The annual average incidence was 102.13/100,000,and it was higher in Yinchuan and Wuzhong than that in other areas. Cases occurred mainly in May and July,and accounted for 58.44% of reported cases. The ratio of male to female cases was 1.52∶1,and children aged 0～4 years accounted for 82.48% of cases. A total of 6,832 cases were confirmed using real-time PCR,and the percentage for CV-A16,EV-A71 and other EVs was 36.85%,32.63% and 30.52%,respectively. The main pathogen of severe cases was EV-A71(77.49%). The dominant type alternated among EV-A71,CV-A16 and other EV. HFMD tended to be seasonal,and children under 5 years old should be the focus for HFMD prevention and control.
Hand,foot and mouth disease(HFMD) is one kind of self-limited infectious disease and very common in children. However, a few cases will become severe ones, even deaths. To analyze the epidemiological and pathogenic characteristics of hand,foot and mouth disease(HFMD) in Ningxia Hui Autonomous Region,China,from 2009 to 2017,the descriptive epidemiological methods were used to analyze surveillance data and etiological results from 2009 to 2017. Real-time polymerase chain reaction(PCR)was employed to detect enterovirus A71(EV-A71),coxsackievirus A16(CV-A16)and other enterovirus(EV)from collected specimens. From 2009 to 2017,59,281 cases,191 severe cases and 13 deaths were reported. The annual average incidence was 102.13/100,000,and it was higher in Yinchuan and Wuzhong than that in other areas. Cases occurred mainly in May and July,and accounted for 58.44% of reported cases. The ratio of male to female cases was 1.52∶1,and children aged 0～4 years accounted for 82.48% of cases. A total of 6,832 cases were confirmed using real-time PCR,and the percentage for CV-A16,EV-A71 and other EVs was 36.85%,32.63% and 30.52%,respectively. The main pathogen of severe cases was EV-A71(77.49%). The dominant type alternated among EV-A71,CV-A16 and other EV. HFMD tended to be seasonal,and children under 5 years old should be the focus for HFMD prevention and control.
引文
[1]许文波,檀晓娟.手足口病:中国儿童传染病防控面临的新挑战[J].疾病监测,2009,24(9):649-650.
[2]中国疾病预防控制中心.手足口病预防控制指南(2009版)[EB/OL].(2009-06-12)
[3]中国疾病预防控制中心.手足口病实验室手册(第4版)[EB/OL].(2010-06-12)
[4]张进,史永林,吴家兵,胡万富,黄芬.安徽省2008-2012年手足口病流行病学及病原学特征分析[J].中华疾病控制杂志,2014,18(6):497-500.
[5]Chen K T,Chang H L,Wang S T,Cheng Y T,Yang JY.Epidemiologic features of hand-foot-mouth disease and herpangina caused by enterovirus 71 in Taiwan,1998-2005[J/OL].Pediatrics,2007,120(2):e244-e252.
[6]Podin Y,Gias E L,Ong F,Yee-Wei Leong Y W,Yee SF,Yusof M A,Perera D,Teo B,Wee T Y,Yao S C,Yao S K,Kiyu A,Arif M T,Cardosa M J.Sentinel surveillance for human enterovirus 71 in Sarawakm,Malaysia lessons from the first 7 years[J].BMC Public Health,2006,6:180.
[7]Weng Y W,Chen W,Huang M,He W X,Zheng K C,Yan Y S.Epidemiology and etiology of hand,foot,and mouth disease in Fujian Province,2008-2014[J].Arch Virol,2016,123(10):1-8.
[8]蔡剑,陈恩富,顾华,柴程良,傅桂明,王笑笑.2008-2013年浙江省手足口病时空扫描聚集性分析[J].中华预防医学杂志,2014,48(6):451-455.
[9]李幸乐,李懿,张白帆,隋美丽,潘静静,陈志娟,程宁宁,杜燕华,卫海燕,许汴利,黄学勇.河南省2014年手足口病重症病例病原学分析[J].中华流行病学杂志,2016,37(4):568-571.
[10]杨韵青,耿兴义,刘晓雪,王蔚茹,张济.气候因素对济南市5岁以下儿童手足口病发病短期效应研究[J].中华预防医学杂志,2015,49(12):1052-1055.
[11]黄学勇,康锴,许玉玲,卫海燕,李幸乐,马宏,尤爱国,陈豪敏,许汴利.2008-2011年河南省手足口病患儿病原体病原学监测结果[J].中华预防医学杂志,2012,46(10):883-887.
[2]中国疾病预防控制中心.手足口病预防控制指南(2009版)[EB/OL].(2009-06-12)
[3]中国疾病预防控制中心.手足口病实验室手册(第4版)[EB/OL].(2010-06-12)
[4]张进,史永林,吴家兵,胡万富,黄芬.安徽省2008-2012年手足口病流行病学及病原学特征分析[J].中华疾病控制杂志,2014,18(6):497-500.
[5]Chen K T,Chang H L,Wang S T,Cheng Y T,Yang JY.Epidemiologic features of hand-foot-mouth disease and herpangina caused by enterovirus 71 in Taiwan,1998-2005[J/OL].Pediatrics,2007,120(2):e244-e252.
[6]Podin Y,Gias E L,Ong F,Yee-Wei Leong Y W,Yee SF,Yusof M A,Perera D,Teo B,Wee T Y,Yao S C,Yao S K,Kiyu A,Arif M T,Cardosa M J.Sentinel surveillance for human enterovirus 71 in Sarawakm,Malaysia lessons from the first 7 years[J].BMC Public Health,2006,6:180.
[7]Weng Y W,Chen W,Huang M,He W X,Zheng K C,Yan Y S.Epidemiology and etiology of hand,foot,and mouth disease in Fujian Province,2008-2014[J].Arch Virol,2016,123(10):1-8.
[8]蔡剑,陈恩富,顾华,柴程良,傅桂明,王笑笑.2008-2013年浙江省手足口病时空扫描聚集性分析[J].中华预防医学杂志,2014,48(6):451-455.
[9]李幸乐,李懿,张白帆,隋美丽,潘静静,陈志娟,程宁宁,杜燕华,卫海燕,许汴利,黄学勇.河南省2014年手足口病重症病例病原学分析[J].中华流行病学杂志,2016,37(4):568-571.
[10]杨韵青,耿兴义,刘晓雪,王蔚茹,张济.气候因素对济南市5岁以下儿童手足口病发病短期效应研究[J].中华预防医学杂志,2015,49(12):1052-1055.
[11]黄学勇,康锴,许玉玲,卫海燕,李幸乐,马宏,尤爱国,陈豪敏,许汴利.2008-2011年河南省手足口病患儿病原体病原学监测结果[J].中华预防医学杂志,2012,46(10):883-887.