贵州省2008-2015年手足口病病原学监测分析

Virologic surveillance of hand,foot and mouth disease in Guizhou province,2008-2015

目的了解贵州省2008-2015年手足口病(Hand,foot and mouth disease,HFMD)病原谱构成和分布特征,为HFMD预防控制提供参考。方法收集贵州省各市(州)采集的HFMD病例标本和临床信息,并采用Real time-PCR检测肠道病毒(EV)感染状况,进行描述性分析。结果 2008-2015年共收集和检测30 069份HFMD病例标本,其中EV阳性16 122份(53.62%)。在EV阳性标本中,肠道病毒A71型(EV-A71)阳性5 004份(31.04%),柯萨奇病毒A16型(CV-A16)阳性3 532份(21.91%),EV-A71和CV-A16均阳性145份(0.90%),其他EV阳性7 441份(46.15%)。六盘水、黔西南州和铜仁市以EV-A71感染为主,其他6个市(州)以其他EV感染为主。3-5月为感染季节高峰,1岁组为感染年龄高峰。轻型病例以其他EV感染居多(48.17%),重症和死亡病例以EV-A71(51.42%和83.64%)居多。结论贵州省大部分地区HFMD流行的病原谱发生变化,需进一步加强监测工作。

Objective To determine the spectrum of pathology of hand,foot and mouth disease（HFMD）from 2008 to 2015 in Guizhou,and to provide laboratory evidence for prevention and control of HFMD.Methods Specimens and epidemiological information of HFMD cases were collected from all prefectures. Enterovirus（EV） infections were detected by real-time PCR and were used for descriptive analyses. Results A total of 30 069 specimens from HFMD cases were collected from 2008 to 2015; 16 122（53. 62%） specimens were EV positive. Among the EV strains,5 004（31. 04%） were enterovirus A71（EV-A71）; 3 532（21. 91%） were coxsackievirus A16（CV-A16）; 145（0. 90%） were both EV-A71 and CV-A16; and 7 441（46. 15%） were other EVs. EV-A71 was dominant in the prefectures of Liupanshui,Qianxinan and Tongren,and other EVs were dominant in the other 6 prefectures. Infections peaked from March to May,and among the 1-year-old group. Mild HFMD cases were most commonly caused by other EVs（48. 17%）,and severe and fatal cases were mainly caused by EV-A71（51. 42%and 83. 64%）. Conclusions Virologic causes of HFMD have changed in most areas of Guizhou.Surveillance of HFMD cases should be further strengthened.