贵州省2013年-2014年手足口病聚集性疫情病原监测分析

Pathogenic surveillance and analysis of hand-foot-mouth disease clustering epidemics in Guizhou from 2013 to 2014

目的了解贵州省手足口病聚集性疫情病原谱及变迁。方法各县（市、区）收集手足口病聚集性疫情基本信息及患者标本送属地市（州）疾病预防控制中心,标本用real-time PCR技术检测肠道病毒,对结果进行描述性分析。结果共对870起聚集性疫情的1 742例患者的粪便和/或肛拭子、咽拭子标本检测,检出率为77.82%,感染率为73.36%。单一感染中其他肠道病毒最多,占32.20%;混合感染以EV71＋其他肠道病毒感染居多,占7.53%;每年的感染谱有所不同。九市（州）均有肠道病毒检出,检出率以毕节市最高（89.91%）,贵阳市最低（35.29%）,差异有统计学意义（χ-2=123.73,P=0.00）,各地优势病毒型别发生变迁。各月均有肠道病毒检出,检出主峰为3月-5月,（59.08%）,次峰为10月（6.79%）。不同场所聚集性疫情均存在肠道病毒的单一感染和混合感染。结论贵州省手足口病聚集性疫情病原多样,优势病毒型别随年度病原谱变化而变化,需加强监测、传染源管理及健康教育等工作。

Objective To explore pathogenic spectrum and its changing rule of the clustering epidemics of hand- foot- mouth disease（ HFMD） in Guizhou. Methods The basic epidemiological information and samples were collected from cases happened in the clustering epidemics of HFMD and sent to prefecture centers or county centers for detecting enteroviruses by real- time PCR. And the results were analyzed through descriptive methods. Results A total of 1 742 samples（ pharyngeal swab and / or anal swab） from cases involved in 870 clustering epidemics of HFMD were tested. The positive rate of enterovirus was 77. 82%.The infection rate was 73. 36%. The other enterovirus were the primary pathogen and accounted for 32. 20% as the single infectious pathogen of the clustering epidemics. The combined EV71 and other enteroviruses were the primary mixed infectious pathogen and accounted for 7. 53%; the infection spectrums were different in each year. Enterovirus existed in all 9 prefectures. The detection rate in Bijie was the highest（ 89. 91%）,the lowest rate（ 35. 29%） was in Guiyang. The difference was statistically significant（ χ-2= 123. 73,P = 0. 00）,and the dominant type of virus changed in different areas. Intestinal virus were detected in each month,and there were two peaks in the curve,the main peak was from March to May,accounting for 59. 08%,the second peak was in October,accounting for 6. 79%. The clusterings in different places were related to both single and mixed enteroviruses infections. Conclusion The pathogenic spectrum of HFMD clustering in Guizhou was diverse,the dominate virus type changed with pathogenic spectrum of each year. As a result,there is an urgent need to strengthen monitoring,controlling of infection source,and the health propaganda work.