2014—2018年汉中市手足口病病原学监测结果分析

Analysis of etiology monitoring results of hand, foot and mouth disease in Hanzhong City from 2014-2018

目的了解2014—2018年汉中市手足口病病原型别变化和流行趋势,为手足口病防控提供科学依据。方法对汉中市11个县区医疗卫生机构送检的咽拭子样本用荧光定量聚合酶链式反应(PCR)方法进行手足口病相关病毒核酸检测。结果1555份样本中检出肠道病毒824份,阳性率为52.99%,肠道病毒71型(EV71)、柯萨奇病毒A组16型(CA16)、其他肠道病毒(EV)构成比分别为14.8%、17.6%、67.6%;557份EV1阳性样本中,柯萨奇病毒A组6型(CA6)、柯萨奇病毒A组10型(CA10)和未分型分别占78.2%、5.0%和16.8%,占全部肠道病毒阳性的52.8%、3.4%和11.4%;不同性别阳性率比较,差异无统计学意义(χ~2=1.883,P>0.05);不同年份间和年龄组间的阳性率差异均有统计学意义(均P<0.05)。结论2014—2018年汉中市手足口病发病率基本呈现逐年上升趋势,且呈明显的季节性,主要以非EV71和CA16肠道病毒为主,CA6成为手足口病主要病原,手足口病主要发生在5—7和11月,1~4岁儿童将是今后重点防控对象。

Objective To understand the pathogenic type change and epidemic trend of hand,foot and mouth disease(HFMD)in Hanzhong City from 2014-2018,provide scientific basis for prevention and control of HFMD.Methods Real-time RT-PCR was used to detect the nucleic acid of HFMD related virus in pharyngeal swab samples collected from medical and health institutions in 11 counties and districts of Hanzhong City.Results 824 of 1555 samples were positive for enterovirus,and the positive rate was 52.99%.The constituent ratios of Enterovirus 71(EV71),Coxsackie virus A16(CA16)and other Enteroviruses(EV)were14.8%,17.6%and 67.6%,respectively.Among 557 positive samples of other EV,Coxsackie virus A6(CA6),Coxsackie virus A10(CA10)and untyped samples accounted for 78.2%,5.0%and 16.8%,respectively,accounting for 52.6%,3.4%and 11.4%of all enterovirus positive samples.There was no statistically significant difference in the positive rate between sex groups(χ2=1.883,P>0.05),and the differences in the positive rate were statistically significant among groups in different years and ages(P<0.05).Conclusion The incidence of HFMD in Hanzhong City from 2014-2018 is increasing year by year,showing obvious seasonality.Most of cases are caused by non-EV71 and CA16 enteroviruses,and CA6 is the main pathogen of HFMD.HFMD cases mainly occur in May-July and November.Children aged 1-4 years will be the focus of prevention and control in the future.