广东省某两地区2018-2019年手足口病病原学检测及流行病学特征分析

Etiological and epidemic characteristics of HFMD in Guangdong province from 2018 to 2019

目的分析2018-2019年广东地区手足口病(HFMD)的流行病学和病原学构成特征,为广东地区HFMD防控提供依据。方法采用描述性流行病学方法对2018年9月-2019年4月广东省高州市和阳春市手足口病监测病例进行流行病学特征及病原学分型分析;采用荧光PCR(RT-PCR)方法对临床诊断为手足口病监测病例的标本进行核酸检测。结果主动监测到可疑手足口病病例209例,其中实验室确诊病例184例,柯萨奇病毒A16型(CA16)、肠道病毒71型(EV71)、CA6、CA10和其他肠道病毒分别占总阳性数的55.43%、0.54%、24.46%、1.09%和18.48%。男女性别比为1.56∶1。发病主要集中在1~<6岁儿童(165例,占89.67%)。职业分布中占比较多的群体为散居儿童(58.70%)、幼托儿童(34.24%)。不同性别、年龄、职业分布、治疗情况、预后、临床症状、疫苗接种情况间实验室确诊病例检出率差异无统计学意义(P>0.05)。结论2018-2019年广东省高州市和阳春市手足口病的病原中CA16和CA6成为优势病原。手足口病病原学监测还需加强HFMD其他肠道病毒进一步分型检测分析,研究包括CA16在内的多型别手足口病疫苗应为未来发展方向。

Objective To analyze the epidemiological characteristics,etiological characteristics of hand foot and mouth disease(HFMD)in Guangdong from 2018 to 2019,and provide evidence for prevention and control.Methods Descriptive epidemiologic methods were used to analyze epidemiological characteristics and etiological surveillance cases of HFMD from September 2018 to April 2019 in Gaozhou and Yangchun city.RT-PCR method was used to perform nucleic acid detection on specimens of clinically diagnosed cases of HFMD.Results There were 209 suspected HFMD cases were actively monitored,including 184 laboratory confirmed cases.Coxsackievirus A16(CA16),enrerovirus 71(EV71),CA6,CA10 and other enterovirus types accounted for 55.43%,0.54%,24.46%,1.09%and 18.48%of the total positive numbers,respectively.The male-to-female ratio was 1.56∶1.The incidence was mainly concentrated among children aged 1 to<6 years old(165 cases,accounting for 89.67%).The major occupational distribution groups were scattered children(58.70%)and kindergarten children(34.24%).There were no significant differences in pathogen in different gender,age,occupation,treatment status,prognosis,types of enterovirus and vaccination status(P>0.05).Conclusions CA16 and CA6 were the dominant types of enterovirus pathogens of HFMD in Guangdong in 2018-2019.Further typing and analysis of other enteroviruses should also be strengthened for the monitoring and research on multi type HFMD vaccine containing CA16.