手足口病流行期健康儿童及其监护人肠道病毒带毒状况调查

Investigation of the prevalence of enterovirus carriers among healthy children and their guardians during HFMD outbreaks

目的了解5岁以下儿童及监护人肠道病毒携带情况,分析健康人群带毒情况及其在手足口病传播过程中的作用。方法 2010年分别于手足口病流行前期、流行高峰期和流行后期,在济宁市泗水县和嘉祥县随机采集城镇托幼机构儿童和农村散居儿童及其监护人的粪便标本,荧光定量PCR检测肠道病毒核酸。结果健康人群肠道病毒带毒率在手足口病流行期最高(20.10%),其次是流行前期和流行后期(14.56%和8.29%)。5岁以下儿童带毒率高于成人,其中3岁以下儿童带毒率最高。三次调查共检出肠道病毒核酸阳性标本177份,99.44%(176/177)鉴定为其他肠道病毒,未检测出EV71型肠道病毒,仅检测出1例CoxA16型肠道病毒。结论 5岁以下健康儿童及监护人肠道病毒带毒较为普遍,夏季带毒率较高;EV71型和CoxA16型肠道病毒核酸检测阳性率较低,提示健康人群肠道病毒带毒在手足口病传播中的作用不大。

Objective To ascertain the prevalence of enterovirus carriers among healthy children under five years of age and their guardians in order to analyze the prevalence of virus carriers among healthy people and their role in the transmission of HFMD.Methods Fecal specimens were collected from children and their guardians by random sampling of urban nurseries and kindergartens and rural villages in Sishui County and Jiaxiang County in the early stages of an HFMD outbreak（March-April）,at the peak of the outbreak（June-July）,and in the later stages of the outbreak（October-November） in 2010.Enterovirus nucleic acids were detected by real-time PCR.Results The prevalence of enterovirus carriers among healthy people was 20.10% at the peak of the HFMD outbreak,14.56% in the early stages of the outbreak,and 8.29% in the later stages of the outbreak.The prevalence of enterovirus carriers was higher among children under five years of age than among adults.The highest prevalence of enterovirus carriers was among children under three years of age.According to real-time PCR,177 fecal specimens tested positive for human enteroviruses,and 99.44%（176/177） were identified as other enterovirus infections.None of the specimens tested positive for EV71,though one sample tested positive for CoxA16.Conclusion There was a considerable prevalence of enterovirus carriers among healthy children under five years of age and their guardians,and this was especially true in summer.There were rather low rates of positivity for EV71 and CoxA16.This means that healthy people who test positive for enterovirus nucleic acids may have nothing to do with the spread of HFMD.