2014-2017年玉林市手足口病监测结果分析

Analysis of the surveillance results of hand,foot and mouth disease in Yulin City in 2014-2017

目的分析玉林市手足口病发病情况及其病原谱的构成,为手足口病的诊断、治疗及其防控提供科学依据。方法收集2014年1月至2017年12月玉林市红十字会医院临床诊断为手足口病患者的肛拭子标本32 077例,应用实时荧光定量-聚合酶链反应(q RT-PCR)技术对标本进行病毒核酸检测,并分析病毒类型与临床相关性。结果肠道病毒阳性率为80.1%(25 870/32 077),其中EV71型、CA16型及非EV71/CA16型阳性检出率分别为12.4%(3 203/25 870)、5.4%(1 402/25 870)及82.2%(21 265/25 870),以非EV71/CA16型为主;非EV71/CA16组与CA16组、EV71组在各年龄组中分别比较,差异具有统计学意义(P<0.01),在男性与女性之间的阳性率的比较,差异无统计学意义(P>0.05)。手足口病各月均可发病,具有明显的季节性,病例数主要集中在4～9月。结论 2014-2017年玉林市手足口病病原谱发生变化,非EV71/CA16的肠道病毒成为优势流行株,因此应加强未分型样本的监测工作。应重视儿童手足口的诊治、日常监测和防控工作。

Objective To analyze the incidence of hand-foot-mouth disease(HFMD)and its pathogen spectrum in Yilin city,and to provide a scientific basis for the diagnosis,treatment and prevention of HFMD.Methods A total of 32 077 anal swab specimens from patients with HFMD diagnosed in Yulin Red Cross Hospital from January 2014 to December 2017 were collected.The real-time fluorescence quantitative-polymerase chain reaction(qRT-PCR)technique was used to detect viral nucleic acid samples and analyze the virus type and clinical relevance.Results The positive rate of enterovirus was 80.1%(25 870/32 077).The positive detection rates of EV71,CA16 and non-EV71/CA16 were 12.4%(3 203/25 870),5.4%(1 402/25 870)and 82.2%(21 265/25 870),respectively.Non-EV71/CA16 type was the main type.There was a significant difference between non-EV71/CA16 group and CA16 or EV71(P<0.01).The positive rate between male and female was not statistically significant difference(P>0.05).The incidence of HFMD has obvious seasonality of HFMD and the number of cases is mainly concentrated from April to September.Conclusion The pathogen spectrum of HFMD in Yulin city has changed in 2014-2017,and the non-EV71/CA16 enterovirus became the dominant strain.Therefore,the monitoring of untyped samples should be strengthened.More attention should be paid to the diagnosis,treatment,daily monitoring and prevention and control of HFMD.