2011-2015年苏州市手足口病相关病原监测

Epidemic characteristics of hand, foot and mouth disease related virus in Suzhou from 2010 to 2015

目的 对苏州市2010-2015年的手足口病相关病毒进行病原学监测分析,为苏州市预防和控制手足口病提供科学依据.方法 以苏州每个区为单位,每月采集至少五个轻症病例标本,重症病例均采样,采用实时荧光PCR方法进行病毒核酸检测,并对结果信息进行描述分析.结果苏州市2011-2015年共采集手足口病标本4 552份,检测结果为阳性的手足口标本2 818份（总阳性率为61.90%）,相邻年份阳性率差异有统计学意义（x2=186.09,P〈0.0001）.手足口病主要感染1~5岁的儿童,其中66.17%是1~3岁儿童.EV71和CVA16是苏州市2011、2012年和2014年手足口病主要的病原;重症病例主要与EV71感染有关,2013年的肠道病毒其他亚型占主导地位,重症患者显著减少.结论 EV71和CVA16仍然是苏州市手足口病的重要病原体,但其他亚型的肠道病毒也占有一定比例,建议从肠道病毒的非EV71和CVA16中选择个别优势手足口病病原纳入手足口病监测.

Objective To investigate the epidemical features, etiological and clinical characteristics of HFMD in Suzhou city, from 2011 to 2015, providing the scientific supports for HFMD prevention and control.Methods In each district of Suzhou city, at least five specimens of mild cases were collected per month, while all of the severe cases were sampled.The RNA from each sample was examined using a commercially available real-time PCR kit.Statistical analysis was performed using SPSS version 11.5 software.Results We retrospectively analyzed HFMD epidemiological data in Suzhou from 2011 to 2015, a total of 4 552 outpatients in Suzhou city were diagnosed with HFMD, including 2 818 positive specimen, the total positive rate was 61.90%, and there was a significant difference in the positive rates between the adjacent years （x2=186.09,P〈0.0001）.From 2011 to 2015 in Suzhou, HFMD mainly affected children aged 1 to 5 years old, 66.17% of them were 1to 3 years old.Enterovirus 71（EV71） and coxsackievirus A16（CVA16） were the predominant viral genotypes in Suzhou from 2011 to 2012, and 2014.In 2013, other EVs were dominant, the severe cases mainly correlated with EV71 subtypes, and the proportion of patients with severe disease was significantly decreased in 2013.Conclusions EV71 and CVA16 are still the important pathogens of HFMD, other EVs also occupy a certain proportion, it is the time to select one or two advantage pathogens from the other EVs into the HFMD monitoring.