2017-2018年江苏省苏州市手足口病病原学及重症监测分析

Etiological and intensive surveillance of hand-foot-mouth disease in Suzhou of Jiangsu Province from 2017 to 2018

目的对苏州市2017-2018年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。方法以苏州市各区为单位,每月采集至少5份轻症病例标本,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2017-2018年共采集手足口病病例标本1 377份,检测结果为阳性的1 085份(总阳性率78.79%),各年阳性率分别为79.38%和82.48%,差异无统计学意义(χ^2=2.11,P=0.15)。EV 71和CA16是苏州市2017年手足口病主要病原,CA6是2018年手足口病主要病原;2017年重症病例主要与EV 71感染有关,EV 71占重症病例总数的67.05%,2018年重症病例的主要病原为EV 71和CA6,其病例分别占重症病例总数的22.72%和20.45%;手足口病的优势病原体由2017年的EV 71和CA16转变为2018年的CA6,CA16和其他肠道病原为辅,重症病例2018年比2017年显著减少。结论手足口病重症病例明显减少可能与手足口病EV 71疫苗的普及有关。建议加强疫苗宣传,加强手足口病监测,控制手足口病的传播,进一步减少重症病例。

Objective To investigate the etiological surveillance of hand-foot-mouth disease(HFMD)in Suzhou from 2017 to 2018,in order to provide the scientific evidences for HFMD prevention and control.Methods In each district of Suzhou City,at least five specimens of mild cases and all samples of severe cases were collected per month.The RNA of each sample was examined by commercially available real-time PCR kits.Then the descriptive analysis of data was conducted by using SPSS 11.5.Results A total of 1377 samples of HFMD were collected in Suzhou from 2017 to 2018.And 1085 samples were tested positive(the total positive rate was 78.79%).The positive rates of those two years were 79.38%and 82.48%,respectively.There was no statistically significant difference(χ^2=2.11,P=0.15).EV 71 and CA16 were the main pathogens of HFMD in 2017,while CA6 was the main pathogen in 2018.In 2017,severe cases were mainly related to EV 71 infection,accounting for 67.05%of the total severe cases.In 2018,the main pathogens of severe cases were EV 71 and CA6,which accounted for 22.72%and 20.45%,respectively.The dominant pathogens of HFMD changed from EV 71 and CA16 in 2017 to CA6 in 2018,supplemented by CA16 and other intestinal pathogens.And the number of severe cases decreased obviously from 2017 to 2018.Conclusion Significant reduction of severe cases may be related to the popularity of EV 71 vaccine.It is suggested to strengthen vaccine propaganda,enhance HFMD surveillance,to further control the spread of HFMD and reduce severe cases.