乡镇卫生院手足口病病原检测研究
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摘要
目的了解乡镇手足口病病原分布特征和流行情况,为疾病防控提供科学依据。方法采集2013年-2015年乡镇卫生院首次就诊临床诊断手足口病病例标本312份,应用实时荧光PCR方法检测手足口病肠道病毒通用型(EV)、肠道病毒71型(EV71)、柯萨奇病毒CVA16、CVA6、CVA10型。结果共采集标本312份,肠道病毒检出率为58.65%。2013年优势病原为CVA6,占57.89%;2014年优势病原为CVA16,占38.37%;2015年优势病原为CVA6,占32.20%。高发年龄为1岁~5岁;发病人群以托幼儿童和散居儿童为主,托幼儿童阳性率高于散居儿童,差异具有统计学意义(P<0.05)。结论 CVA6在2013年-2015年海盐县手足口病病原谱中占有优势,CVA10也有潜在威胁。建议手足口病常规监测中增加对CVA6和CVA10及其他未定型肠道病毒的监测,加大重点人群的监管力度,有效控制重症病例和聚集性病例的发生。
Objective To understand the etiologic and epidemiological characteristics of hand- foot and mouth disease( HFMD) in villages and towns,so as to provide scientific basis for the disease control and prevention. Methods 312 specimens were collected from the clinical diagnosed HFMD cases in the hospitals of villages and towns,and the EV,EV71,CVA16,CVA6,CVA10 were detected by real- time fluorescent quantitative RT- PCR. Results A total of 312 samples were collected,and the detection rate of intestinal virus was 58. 65%. The dominant pathogen in 2013,2014 and 2015 were CVA6,CVA16 and CVA6,accounting for 57. 89%,38. 37%,32. 20% respectively. The cases were mainly concentrated in the 1- 5age group,who were mainly scattered children and kindergarten children,and the difference of positive rate was statistically significant( P < 0. 05). Conclusion The predominant type causing HFMD in Haiyan could be CVA6 from 2013 to 2015,and CVA10 also has potential dangers. It is necessary to enhance the monitoring of CVA6 and CVA10 and unclassified enterovirus,and to enhance the supervision on key crowd,so as to effectively control the occurrence of severe cases and clustered cases.
Objective To understand the etiologic and epidemiological characteristics of hand- foot and mouth disease( HFMD) in villages and towns,so as to provide scientific basis for the disease control and prevention. Methods 312 specimens were collected from the clinical diagnosed HFMD cases in the hospitals of villages and towns,and the EV,EV71,CVA16,CVA6,CVA10 were detected by real- time fluorescent quantitative RT- PCR. Results A total of 312 samples were collected,and the detection rate of intestinal virus was 58. 65%. The dominant pathogen in 2013,2014 and 2015 were CVA6,CVA16 and CVA6,accounting for 57. 89%,38. 37%,32. 20% respectively. The cases were mainly concentrated in the 1- 5age group,who were mainly scattered children and kindergarten children,and the difference of positive rate was statistically significant( P < 0. 05). Conclusion The predominant type causing HFMD in Haiyan could be CVA6 from 2013 to 2015,and CVA10 also has potential dangers. It is necessary to enhance the monitoring of CVA6 and CVA10 and unclassified enterovirus,and to enhance the supervision on key crowd,so as to effectively control the occurrence of severe cases and clustered cases.
引文
[1]中华人民共和国卫生部.手足口病预防控制指南(2009年版)[Z].2009-06-04.
[2]梅玉发,王喜云,崔龙,等.湖北省十堰市59例柯萨奇病毒A组6型手足口病流行病学特征与临床特点分析[J].疾病监测,2013,28(12):981-983.
[3]陈炜,翁育伟,何文祥,等.2011-2013年福建省手足口病相关病原柯萨奇病毒A组6型的分子流行病学研究[J].病毒学报,2014,30(6):624-629.
[4]赵蕾,陈敬贤,王明丽.阜阳市手足口病柯萨奇病毒A10型VP4区基因特征分析[J].中华疾病控制杂志,2013,17(6):480-483.
[5]孙坚,童其田,黄美林.宁海县256例手足口病流行病学特征及病原学检测结果分析[J].中国公共卫生管理,2015,31(6):874-875,882.
[6]谢国良,崔大伟,郑书发,等.2013~2014年杭州地区手足口病柯萨奇病毒A6型和A10型VP1基因特征分析[J].临床检验杂志,2015,33(12):938-941.
[7]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.
[8]谭徽,刘爱平,谢群,等.湖南省郴州市2010年-2014年手足口病病原谱的变迁研究[J].中国卫生检验杂志,2015,25(24):4304-4308.
[9]童国强,蒋宝峰,姚凤燕,等.平湖市2010-2014年手足口病流行病学特征分析[J].温州医科大学学报,2016,46(1):75-77.
[10]王恒芹,吴波,郞中凯,等.重庆市万州区在园儿童手足口病病原携带情况调查[J].中国卫生检验杂志,2016,26(4):582-584.
[11]张爽,荆红波,马红梅,等.2011-2014年北京市顺义区手足口病监测结果分析[J].现代预防医学,2016,43(4):730-732,749.
[2]梅玉发,王喜云,崔龙,等.湖北省十堰市59例柯萨奇病毒A组6型手足口病流行病学特征与临床特点分析[J].疾病监测,2013,28(12):981-983.
[3]陈炜,翁育伟,何文祥,等.2011-2013年福建省手足口病相关病原柯萨奇病毒A组6型的分子流行病学研究[J].病毒学报,2014,30(6):624-629.
[4]赵蕾,陈敬贤,王明丽.阜阳市手足口病柯萨奇病毒A10型VP4区基因特征分析[J].中华疾病控制杂志,2013,17(6):480-483.
[5]孙坚,童其田,黄美林.宁海县256例手足口病流行病学特征及病原学检测结果分析[J].中国公共卫生管理,2015,31(6):874-875,882.
[6]谢国良,崔大伟,郑书发,等.2013~2014年杭州地区手足口病柯萨奇病毒A6型和A10型VP1基因特征分析[J].临床检验杂志,2015,33(12):938-941.
[7]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.
[8]谭徽,刘爱平,谢群,等.湖南省郴州市2010年-2014年手足口病病原谱的变迁研究[J].中国卫生检验杂志,2015,25(24):4304-4308.
[9]童国强,蒋宝峰,姚凤燕,等.平湖市2010-2014年手足口病流行病学特征分析[J].温州医科大学学报,2016,46(1):75-77.
[10]王恒芹,吴波,郞中凯,等.重庆市万州区在园儿童手足口病病原携带情况调查[J].中国卫生检验杂志,2016,26(4):582-584.
[11]张爽,荆红波,马红梅,等.2011-2014年北京市顺义区手足口病监测结果分析[J].现代预防医学,2016,43(4):730-732,749.