宁夏回族自治区2013—2014年手足口病病原学分析

Prevalent pathogens of hand,foot and mouth disease in Ningxia Hui Autonomous Region,2013-2014

目的分析2013—2014年宁夏回族自治区手足口病病原学流行特征,探索病原的分布和变化规律,为手足口病的防控提供理论依据。方法对宁夏回族自治区各市县哨点医院采集的患者手足口病标本进行realtime PCR、肠道病毒培养和基因测序型别鉴定;将标本病原鉴定结果和病例流行病学资料相结合,描述不同病原流行病学分布特点。结果 2013—2014年共检测阳性病例标本1 703份,其中CAV16阳性814份(47.8%),EV71阳性479份(28.1%),其他EV阳性410份(24.1%)。CAV16为宁夏2013—2014年优势病毒,2013年以其他EV为第二主要病原,2014年以EV71为第二主要病原。宁夏手足口病发病有明显的季节性,不同年份和地区的病原分布差异均有统计学意义。结论宁夏手足口病病原以EV71、CAV16和其他EV为优势病原交替流行,而且2013—2014年其他EV型别构成变化较大,提示在做好EV71和CAV16防控工作的同时,要更多关注其他EV的变化。

Objective To analyze epidemiological and pathogenic characteristics of hand, foot and mouth disease （HFMD） in Ningxia Hui Autonomous Region（Ningxia） during 2013 -2014 and to provide theoretical evidences for HFMD prevention and control. Methods Data on all registered HFMD cases in Ningxia during the two year period were collected;fecal or throat swab specimens were sampled from all severe and death HFMD cases and the HFMD cases visiting sentinel hospitals （ 5 cases/per hospital/per month） ; enterovirus （EV） culture and isolation were conducted for the speci- mens and the types of the virus isolated were identified with real-time PCR and gene sequencing technology. Descriptive epidemiological method was adopted in data analyses. Results Of 1703 EV positive specimens detected during the period, 814 （47.8%） were Coxsackievirus group A type 16 （ CAV16 ） positive; 479 （28. 1% ） were enterovirus 71 （EV71） positive;and 410 （24. 1% ） were other EV positive. CAV16 was the predominant pathogen of HFMD during 2013 -2014 ;other EV were the second major pathgen in 2013 and EV71 was the second major virus in 2014. An obvious seasonality was observed in the distribution and there were statistically significant differences in spatial and temporal distribution of HFMD pathogens in Ningxia during the period. Conclusion The dominant HFMD pathogens in Ningxia are EV71 ,CAV16 and other EV, with an alternated prevalent trend among the viruses, and the pathogen prevalence trend should be concerned in the control of HFMD epidemic.