2013年临沂市健康人群肠道病毒流行病学调查

An epidemiological investigation of enterovirus among healthy people in Linyi in 2013

目的调查临沂市健康人群肠道病毒隐性感染状况和动态变化,并分析健康人群肠道病毒隐性感染情况与地区流行情况的关系。方法以≤6岁儿童及其监护人425人为调查对象,分别于4、6和9月进行调查,共调查1 275人次。对被调查者粪便标本进行肠道病毒通用型（PE）、肠道病毒71型（EV71）与柯萨奇病毒A16型（CA16）的Realtime PCR检测,对检测结果进行分析。结果 1）在兰山区与平邑县健康人群粪便标本中检出111人次PE与12人次CA16,阳性率分别为8.71%和0.94%,未检出EV71;2）兰山区0-、1-、2-、3-、4-、5-和21-岁年龄组人群肠道病毒核酸阳性率分别为16.67%、23.33%、13.33%、25.83%、12.38%、3.81%和5.00%,平邑县分别为3.33%、20.00%、10.00%、17.50%、2.86%、5.83%和3.33%。除5-6岁年龄组外,在其他年龄组兰山区阳性率均高于平邑县;3）兰山区4、6和9月健康人群肠道病毒阳性率分别为9.93%、24.82%和9.29%,平邑县分别为6.21%、19.31%和6.89%;两县区肠道病毒阳性率均呈现先升高后降低的趋势;4）肠道病毒隐性感染者比例与该地区本年度流行型别呈正相关。结论健康人群肠道病毒隐性感染者比例随季节变化呈先升高后降低的钟形或半钟形的有规律变化;健康人群肠道病毒隐性感染与该地区流行情况密切相关。

Objectives To investigate latent infections with and dynamic changes caused by enterovirus（PE）,enterovirus 71（EV71）,or coxsackievirus A16（CA16）among healthy people in Linyi and to analyze the relationship between latent infection and the prevalence of hand,foot,and mouth disease in Linyi. Methods Four hundred and twenty-five respondents（including 285children≤6and 140guardians）were surveyed in April,June,and September of 2013（1,275responses）.Fecal specimens were collected and tested for PE,EV71,and CA16 using real-time RT-PCR.Those results were analyzed statistically. Results 1）Of the fecal specimens from healthy people in Lanshan and Pingyi counties,111（8.71%）tested positive for PE and 12（0.94%）tested positive for CA16.EV71 was not detected.2）Healthy people in Lanshan County who were 0-1year of age tested positive for enterovirus nucleic acids at a rate of 16.67%,those who were 1-2years of age tested positive at a rate of 23.33%,those who were 2-3years of age tested positive at a rate of13.33%,those who were 3-4years of age tested positive at a rate of 25.83%,those who were 4-5years of age tested positive at a rate of 12.38%,those who were 5-20 years of age tested positive at a rate of 3.81%,and those who were21＋ years of age tested positive at a rate of 5.00%.Healthy people in Pingyi County who were 0-1year of age tested positive for enterovirus nucleic acids at a rate of 3.33%,those who were 1-2years of age tested positive at a rate of 20.00%,those who were 2-3years of age tested positive at a rate of 10.00%,those who were 3-4years of age tested positive at a rate of 17.50%,those who were 4-5years of age tested positive at a rate of 2.86%,those who were 5-20 years of age tested positive at a rate of 5.83%,and those who were 21＋ years of age tested positive at a rate of 3.33%.Positivity for enterovirus nucleic acids was higher in Lanshan County than in Pingyi County among all age groups studied except individuals 5-6years of age.3）Healthy people in Lanshan County tested positive for enterovirus nucleic acids at a rate of 9.93%in April 2013,24.82%in June of that year,and 9.29%in September of that year.Healthy people in Pingyi County tested positive for enterovirus nucleic acids at a rate of 6.21%in April 2013,19.31%in June of that year,and 6.89%in September of that year.Positivity for enterovirus nucleic acids initially increased in the 2counties and then subsequently decreased.4）There was a correlation between the rate of the latent infection and annual outbreaks of hand,foot,and mouth disease. Conclusion After the seasons changed,there were regular changes in the proportion of the healthy population with a latent infection;these changes produced a ＂ bell＂ or ＂ half bell＂ shape.In addition,there was a close relationship between the rate of latent infection and the prevalence of hand,foot,and mouth disease in the 2regions.