2017年北京儿童医院就诊北京地区疱疹性咽颊炎病例分析

Herpangina cases of Beijing area detected in Beijing Children’s Hospital, 2017

目的了解北京儿童医院就诊北京地区疱疹性咽颊炎流行特征和病原学情况,为疱疹性咽颊炎的防控提供依据。方法收集2017年在北京儿童医院就诊治疗的北京地区疱疹性咽颊炎患者的基本信息及病原学监测资料,运用描述性流行病学方法进行分析。结果共纳入符合条件的疱疹性咽颊炎病例6 922例,疾病流行高峰为6-9月,<5岁儿童占86.04%。病原学监测阳性率53.42%(86/161),以其他肠道病毒为主(47/86,54.65%),其次为柯萨奇病毒A组6型(Cox A6)(28/86,32.56%),Cox A10(7/86,8.14%),肠道病毒71型(EV71)(3/86,3.49%)和Cox A16(1/86,1.16%)。7月阳性率最高(76.92%),不同月份阳性率差异有统计学意义(χ^2=29.98,P<0.05),夏秋季病例报告数较多同时肠道病毒阳性率也较高,两者间呈正相关有统计学意义(rs=0.294,P<0.05)。结论2017年北京儿童医院就诊北京地区疱疹性咽颊炎流行高峰为夏秋季,易感人群为<5岁儿童,病原体主要为其他肠道病毒和Cox A6,引起疱疹性咽颊炎的部分肠道病毒(EV71、Cox A16、Cox A6)可同时引起手足口病,应重视疱疹性咽颊炎,参考手足口病进行疾病预防控制。

Objective To understand the epidemiological and etiological characteristics of herpangina of Beijing area detected in Beijing children’s hospital and provide evidence for the prevention and control of pergangina.Methods The epidemiological and etiological data of herpangina cases were obtained from the surveillance hospital of Beijing area in 2017 for a descriptive epidemiological analysis.Results The data of 6 922 herpangina cases who met the inclusion criteria were analyzed,the incidence peak of herpangina was from June to September.Up to 86.04%of herpangina cases were under 5 years old.The positive rate of pathogen surveillance was 53.42%(86/161),the positive rate of other enteroviruses was highest(54.65%),followed by coxsackievrius A6(Cox A6)(32.56%),Cox A10(7/86,8.14%),entervirus 71(EV71)(3/86,3.49%),Cox A16(1/86,1.16%).The highest pathogen detection rate was in July(76.92%),there were significant differences in pathogen detection rate among different months(χ^2=29.98,P<0.05).Both the reported case number and pathogen detection rate were higher in summer and autumn,showing a positive correlation(rs=0.294,P<0.05).Conclusion The incidence peak of herpangina occurred in summer and autumn,children under 5 years of age were susceptible,and the pathogens were mainly other enteroviruses and Cox A6,some pathogens(EV71,Cox A16,Cox A6)could cause hand foot and mouth disease(HFMD).Close attention should be paid to herpangina and the prevention and control of herpangina can refer to HFMD′s.