2014-2017年玉林市手足口病监测结果分析
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摘要
目的分析玉林市手足口病发病情况及其病原谱的构成,为手足口病的诊断、治疗及其防控提供科学依据。方法收集2014年1月至2017年12月玉林市红十字会医院临床诊断为手足口病患者的肛拭子标本32 077例,应用实时荧光定量-聚合酶链反应(q RT-PCR)技术对标本进行病毒核酸检测,并分析病毒类型与临床相关性。结果肠道病毒阳性率为80.1%(25 870/32 077),其中EV71型、CA16型及非EV71/CA16型阳性检出率分别为12.4%(3 203/25 870)、5.4%(1 402/25 870)及82.2%(21 265/25 870),以非EV71/CA16型为主;非EV71/CA16组与CA16组、EV71组在各年龄组中分别比较,差异具有统计学意义(P<0.01),在男性与女性之间的阳性率的比较,差异无统计学意义(P>0.05)。手足口病各月均可发病,具有明显的季节性,病例数主要集中在4～9月。结论 2014-2017年玉林市手足口病病原谱发生变化,非EV71/CA16的肠道病毒成为优势流行株,因此应加强未分型样本的监测工作。应重视儿童手足口的诊治、日常监测和防控工作。
Objective To analyze the incidence of hand-foot-mouth disease(HFMD)and its pathogen spectrum in Yilin city,and to provide a scientific basis for the diagnosis,treatment and prevention of HFMD.Methods A total of 32 077 anal swab specimens from patients with HFMD diagnosed in Yulin Red Cross Hospital from January 2014 to December 2017 were collected.The real-time fluorescence quantitativepolymerase chain reaction(q RT-PCR)technique was used to detect viral nucleic acid samples and analyze the virus type and clinical relevance. Results The positive rate of enterovirus was 80.1%(25 870/32 077). The positive detection rates of EV71,CA16 and non-EV71/CA16 were 12.4%(3 203/25 870),5.4%(1 402/25 870)and 82.2%(21 265/25 870),respectively.Non-EV71/CA16 type was the main type. There was a significant difference between non-EV71/CA16 group and CA16 or EV71(P<0.01).The positive rate between male and female was not statistically significant difference(P>0.05).The incidence of HFMD has obvious seasonality of HFMD and the number of cases is mainly concentrated from April to September. Conclusion The pathogen spectrum of HFMD in Yulin city has changed in 2014-2017,and the non-EV71/CA16 enterovirus became the dominant strain. Therefore,the monitoring of untyped samples should be strengthened. More attention should be paid to the diagnosis,treatment,daily monitoring and prevention and control of HFMD.
Objective To analyze the incidence of hand-foot-mouth disease(HFMD)and its pathogen spectrum in Yilin city,and to provide a scientific basis for the diagnosis,treatment and prevention of HFMD.Methods A total of 32 077 anal swab specimens from patients with HFMD diagnosed in Yulin Red Cross Hospital from January 2014 to December 2017 were collected.The real-time fluorescence quantitativepolymerase chain reaction(q RT-PCR)technique was used to detect viral nucleic acid samples and analyze the virus type and clinical relevance. Results The positive rate of enterovirus was 80.1%(25 870/32 077). The positive detection rates of EV71,CA16 and non-EV71/CA16 were 12.4%(3 203/25 870),5.4%(1 402/25 870)and 82.2%(21 265/25 870),respectively.Non-EV71/CA16 type was the main type. There was a significant difference between non-EV71/CA16 group and CA16 or EV71(P<0.01).The positive rate between male and female was not statistically significant difference(P>0.05).The incidence of HFMD has obvious seasonality of HFMD and the number of cases is mainly concentrated from April to September. Conclusion The pathogen spectrum of HFMD in Yulin city has changed in 2014-2017,and the non-EV71/CA16 enterovirus became the dominant strain. Therefore,the monitoring of untyped samples should be strengthened. More attention should be paid to the diagnosis,treatment,daily monitoring and prevention and control of HFMD.
引文
[1]ZHANG D,LI R,ZHANG W,et al.A case-control study on risk factors for severe hand,foot and mouth disease[J].Sci Rep,2017(7):40282.
[2]Zhu J,Luo Z,Wang J,et al.Phylogenetic analys is of enterovirus 71 circulating in Beijing,China from2007 to 2009[J/OL].PLo S One,2013,8(2):e56318.
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[4]郭青,张春曦,王晓风,等.2008-2009年中国大陆手足口病流行特征分析[J].疾病监测,2011,26(11):852-856.
[5]张勇,郭彦艳,许学伟,等.2008-2013年安徽省滁州市手足口病流行特征分析[J].职业与健康,2015,31(2):195-198.
[6]胡跃华,肖革新,郭莹,等.2008-2011年中国大陆手足口病流行特征分析[J].中华疾病控制杂志,2014,8(18):693-697,747.
[7]孙军玲,张静.手足口病流行病学研究进展[J].中华流行性学杂志,2009,30(9):973-975.
[8]刘莹莹,于秋丽,苏通,等.2011-2015年河北省手足口病流行特征及病原特征分析[J].中华疾病控制杂志,2017,21(2):151-155.
[9]蒋丽娜,谭毅,王晶,等.2008-2015年广西手足口病流行病学特征及时空聚集性分析[J].中华疾病控制杂志,2017,21(4):340-344.
[10]杭惠,夏瑜,陈立凌,等.2011-2015年苏州市手足口病流行病学特征分析[J].现代预防医学,2016,43(21):3850-3854.
[11]叶瑞国,庞晓泸,蒋宁,等.2010-2011年玉林市手足口病病原学检测结果分析[J].预防医学论坛,2012,18(9):697-698.
[12]朱俊萍,徐子刚,陈辉,等.2007年北京地区儿童手足口病病原的初步筛查[J].病毒学报,2009,25(1):23-28.
[13]关恒云,杨梦婕,刘岚铮,等.Ge XP多重基因表达遗传分析系统对2009-2012年济南市手足口病病原谱的研究[J].病毒学报,2014,30(5):567-571.
[14]葛艳玲,郑亚旭,潘浩,等.2010至2014年上海地区儿童手足口病的流行病学监测[J].中华儿科杂志,2015,9(9):676-683.
[15]Fujimoto T,Iizuka S,Enomoto M,et al.Hand,foot,and mouth disease caused by coxsackievirus A6,Japan,2011[J].Emerg Infect Dis,2012,18(2):337-339.
[16]陈前进,严延生,何家鑫,等.一起Cox Al6引起某幼儿园手足口病暴发调查[J].海峡预防医学杂志,2008,14(1):45-47.
[17]廖琳虹,杨萍,廖亦红,等.2012-2014年龙岩市手足口病病原学监测结果分析[J].中国病原生物学杂志,2015,10(6):536-538.
[18]赵虹,林鸿波,陈懿,等.2012-2013年宁波市鄞州区手足口病病原分析[J].中国卫生检验杂志,2014,24(17):2543-2545.
[19]Han J F,Xu S,Zhang Y,et al.Hand,foot,and mouth disease outbreak caused by coxsackievirus A6,China,2013[J].J infect,2014,69(3):303-305.
[20]邱惠芳,潘丽峰,汤琰,等.上海市浦东新区2013年手足口病检测结果分析[J].中国初级卫生保健,2014,28(9):97-99.
[21]廖琳虹,杨萍,曹春远,等.2014-2015年龙岩市非EV71、非Cox A16手足口病肠道病毒病原谱分析[J].中国卫生检验杂志,2017,27(11):1549-1551.
[22]Feng X,Guan W,Guo Y,et al.A novel recombinant lineage.s contribution to the outbreak of Coxsackievirus A6-associated hand,foot and mouth disease in Shanghai,China,2012-2013[J].Sci Rep,2015,5:11700.
[23]Hong Yan G,Cheng Jie M,Qiao Zhi Y,et al.Hand,foot and mouth disease caused by Coxsackievirus A6,Beijing,2013[J].Pediatr Infect Dis J,2014,33(12):1302-1303.
[2]Zhu J,Luo Z,Wang J,et al.Phylogenetic analys is of enterovirus 71 circulating in Beijing,China from2007 to 2009[J/OL].PLo S One,2013,8(2):e56318.
[3]Li W,Yi L,SU J,et al.Seroprevalence of human entervoirus 71 and coxsackievirus A16 in Guangdong,China,in pre-and post-2010 HFMD epidemic period[J/OL].PLo S One,2013,8(12):e80515.
[4]郭青,张春曦,王晓风,等.2008-2009年中国大陆手足口病流行特征分析[J].疾病监测,2011,26(11):852-856.
[5]张勇,郭彦艳,许学伟,等.2008-2013年安徽省滁州市手足口病流行特征分析[J].职业与健康,2015,31(2):195-198.
[6]胡跃华,肖革新,郭莹,等.2008-2011年中国大陆手足口病流行特征分析[J].中华疾病控制杂志,2014,8(18):693-697,747.
[7]孙军玲,张静.手足口病流行病学研究进展[J].中华流行性学杂志,2009,30(9):973-975.
[8]刘莹莹,于秋丽,苏通,等.2011-2015年河北省手足口病流行特征及病原特征分析[J].中华疾病控制杂志,2017,21(2):151-155.
[9]蒋丽娜,谭毅,王晶,等.2008-2015年广西手足口病流行病学特征及时空聚集性分析[J].中华疾病控制杂志,2017,21(4):340-344.
[10]杭惠,夏瑜,陈立凌,等.2011-2015年苏州市手足口病流行病学特征分析[J].现代预防医学,2016,43(21):3850-3854.
[11]叶瑞国,庞晓泸,蒋宁,等.2010-2011年玉林市手足口病病原学检测结果分析[J].预防医学论坛,2012,18(9):697-698.
[12]朱俊萍,徐子刚,陈辉,等.2007年北京地区儿童手足口病病原的初步筛查[J].病毒学报,2009,25(1):23-28.
[13]关恒云,杨梦婕,刘岚铮,等.Ge XP多重基因表达遗传分析系统对2009-2012年济南市手足口病病原谱的研究[J].病毒学报,2014,30(5):567-571.
[14]葛艳玲,郑亚旭,潘浩,等.2010至2014年上海地区儿童手足口病的流行病学监测[J].中华儿科杂志,2015,9(9):676-683.
[15]Fujimoto T,Iizuka S,Enomoto M,et al.Hand,foot,and mouth disease caused by coxsackievirus A6,Japan,2011[J].Emerg Infect Dis,2012,18(2):337-339.
[16]陈前进,严延生,何家鑫,等.一起Cox Al6引起某幼儿园手足口病暴发调查[J].海峡预防医学杂志,2008,14(1):45-47.
[17]廖琳虹,杨萍,廖亦红,等.2012-2014年龙岩市手足口病病原学监测结果分析[J].中国病原生物学杂志,2015,10(6):536-538.
[18]赵虹,林鸿波,陈懿,等.2012-2013年宁波市鄞州区手足口病病原分析[J].中国卫生检验杂志,2014,24(17):2543-2545.
[19]Han J F,Xu S,Zhang Y,et al.Hand,foot,and mouth disease outbreak caused by coxsackievirus A6,China,2013[J].J infect,2014,69(3):303-305.
[20]邱惠芳,潘丽峰,汤琰,等.上海市浦东新区2013年手足口病检测结果分析[J].中国初级卫生保健,2014,28(9):97-99.
[21]廖琳虹,杨萍,曹春远,等.2014-2015年龙岩市非EV71、非Cox A16手足口病肠道病毒病原谱分析[J].中国卫生检验杂志,2017,27(11):1549-1551.
[22]Feng X,Guan W,Guo Y,et al.A novel recombinant lineage.s contribution to the outbreak of Coxsackievirus A6-associated hand,foot and mouth disease in Shanghai,China,2012-2013[J].Sci Rep,2015,5:11700.
[23]Hong Yan G,Cheng Jie M,Qiao Zhi Y,et al.Hand,foot and mouth disease caused by Coxsackievirus A6,Beijing,2013[J].Pediatr Infect Dis J,2014,33(12):1302-1303.