2013-2015年泉州市手足口病病原学检测及流行病学特征研究

Etiology surveillance and epidemicology analysis of hand foot mouth disease in Quanzhou from 2013 to 2015

目的探讨2013-2015年泉州市手足口病病原学及流行病学特征,为防控工作提供依据。方法对2013-2015年收集的泉州市1 867例实验室监测手足口病病例的咽拭子,经磁珠法提取核酸进行实时荧光PCR检测,对影响手足口病流行的因素进行描述性流行病学分析。结果 1 867例手足口样本中,1 338例核酸检测结果阳性(71.67%),其中EV-A71型385例(28.77%),CV-A16型189例(14.13%),其他肠道病毒型764例(57.10%)。手足口病构成比以高密度区组最高,占50.83%(949/1 867)。发病年龄主要集中于0~5岁儿童,占94.54%(1 765/1 867),尤以1~3岁年龄组幼儿发病最高,占71.51%(1 335/1 867)。男女性别比1.94∶1,检出阳性率男性为73.88%(911/1 233),女性为67.35%(427/634),男性多发于女性,差异有统计学意义(χ~2=8.81,P<0.05)。病例全年均有报告,呈"双峰型"流行,分别于5、6月及10、11月达高峰。结论 2013-2015年发病率逐年增加,除EV-A71型和CV-A16型外,其他肠道病毒都有可能是泉州市手足口病的优势病原体;有明显的季节性、地区和年龄、性别差异,1~3岁男童是易感人群;应在春冬、夏秋双峰型流行期,加强对高人口密度地区3岁以下儿童的手足病防控工作。

Objective To investigate the epidemiologic characteristics of hand-foot-mouth disease （HFMI）） in Quanzhou from 2013 to 2015, and provide basis for the prevention and control of HFMD. Methods Throat swabs were collected from 1867 surveillance cases of HFMD in Quanzhou between 2013 and 2015. Beads ex traction of nucleic acids were tested by real time fluorescent PCR with universal primers of enterovirus as well as specific primers of EV A71 and CV A16. Results A total of 1 867 HFMD cases, 1 338 were idcnlified its HFMDpositive, including 385 positive for EV-A71 （28.77%）, 189 forCV A16 （14. 13%）, and 764 forotb er enterovirus （57. 10%） .The largest proportion of HFMD occurred in densely populated area group, reached 50.83% （949/1 867） .Majority of patients were under 5 years old, accounting to 94.54% （1 765/ 1 867） .71.51% （1 335/1 867） of them were from 1 to3 years old. The ratio of male to female was 1.9,1 ： 1, and the positive rates were 73.88% （911/1 233） in male patients was significantlyhighcr than that of 67.35% （427/634） in females （x^2=8.81, P〈0.05） .The Epidemic situation in Quanzhou was represented as twin peaks, which were in May or June, and then October or November, respectively. Conclusions The morbid ity was increasing year by year, with the other intestinal virus gradually becomeing dominant virus other than EV AT1 or CV A16 infection. HFMD incidence was high for the psychological well being of one to three years old boys, and outbreak was season, region, age, and gender dependent. Accordingly, prevention and control measures should be strengthened in densely populated arca and children under 3 years of age before the epidemic peaked in the late spring and early summer, along with a second peak in late autumn and early winter.