2014年杭州地区手足口病流行病学特点及与气象的相关性研究

Current characteristics of Hand-foot-mouth disease and relationship with meteorological factorsin Hangzhou in 2014

目的 探讨2014年杭州地区手足口病的流行病学特征及病原学特点,以及手足口病发病率及病原体时间分布与气象因素的关系。方法 对2014年杭州地区手足口病的临床病例进行流行病学特点分析,同时利用实时荧光定量聚合酶链反应检测临床获得的咽拭子标本,对其进行病毒核酸检测;对手足口病病例及病原体的时间聚集性与当地的气象情况进行相关性分析。结果 2014年杭州地区共临床诊断手足口病病例6 640例,男女比例为1.44∶1,年龄以1～3岁为主,以本地区散居儿童居多;对临床诊断的住院病例2 370份标本检测结果显示：柯萨奇病毒A16型（CA16）242例,阳性率为10.2%,肠道病毒71型（EV71）936例,阳性率为39.5%,其他肠道病毒1 192例,阳性率为50.3%。手足口病病例时间聚集以5～7月份为高峰,并且手足口病高峰期（5～7月）病原学以EV71为主;手足口病发病率及病原体分布与平均气温、降雨量和相对湿度均呈正相关（P均〈0.05）;且EV71主分布在平均气温高、降雨量大和相对湿度高的月份,而肠道病毒通用型主分布在平均气温较低、降雨量少和相对湿度低的月份。结论 杭州地区2014年手足口病仍以1～3岁散居男童为主,病原学以EV71及肠道病毒通用型为主;手足口病病例时间聚集以5～7月份为主。手足口病发病率及病原体分布情况与平均气温、降雨量及相对湿度呈密切相关。

Objective To investigate the epidemiological characteristics and etiological characteristics of hand-foot-mouth disease in Hangzhou in 2014, andstudy on the relationship between morbidity and seasonal influences on the distribution of pathogens. Methods The epidemiological featuresof hand-foot-mouth disease patients in Hangzhou area in 2014 were an- alyzed. The real-time fluorescence quantitative polymerase chain reaction was performed to detect the levels of virus nucle- ic acid from throat swab specimens. The correlations of time-place clustering with the local weather were analyzed. Results A total of 6 640 cases of hand-foot-mouth disease were reported, the ratio of male to female was 1.44： 1, age 1 -3 years old,and the mainpopulation were local scattered children, in Hangzhou,2014. The tests for 2 370 specimens showed that Coxsackie virus type A16 （CA16） accounted for 242 cases with a positive rate of 10.2%, enterovirus 71 （ EV71 ） for 936 cases with a positive rate of 39.5% ,other intestinal virus for 1 192 cases with apositive rate of 50.3%. The peak period for cluster of hand-foot-mouth disease was during May and July with EVT1 as the main pathogens. The morbidity and distribution of pathogen were positively correlated with the average temperature, rainfall and relative humidi- ty （P 〈 0.05 ）. And EV7I distributed mainly in the months of the high average temperature, rainfall and relative humidity, however,the universal enterovirus mainly distributed in the months of lower average temperature,rainfall and relative hu- midity. Conclusion The hand-foot-mouth disease mainly attack the scattered boy aged 1 to 3 years old in Hangzhou in 2014,EV71 and universal enterovirus are themainpathogens. The peak period for cluster of hand-foot-mouth disease was during May and July. The morbidity and distribution of pathogen were positively correlated with the average temperature, rainfall and relative humidity.