2011-2019年甘孜藏族自治州手足口病流行病学及病原学特征分析

Analysis of the epidemiological and etiological characteristics of hand,foot and mouth disease in Ganzi Tibetan Autonomous Prefecture from 2011 to 2019

目的分析2011-2019年四川省甘孜藏族自治州手足口病流行病学及病原学特征,旨在为手足口病的防治提供参考依据。方法通过实时荧光定量PCR对345份手足口病疑似病例的咽拭子进行检测,并分析手足口病流行病学及病原学特征。结果345例手足口病疑似病例中PCR检测阳性率为62.61%(216/345)。其中藏族感染率为66.44%,汉族为33.33%,差异有统计学意义(χ^(2) =17.129,P<0.05)。不同年龄组感染率之间差异有统计学意义(χ^(2) =11.019,P<0.05),其中3岁以下幼儿感染率最高,为69.01%;寺庙喇嘛和农民感染率76.47%,散居幼儿组71.18%,幼托组58.57%,学生组43.84%,各组间差异有统计学意义(χ^(2) =18.225,P<0.05)。2011-2019年甘孜州手足口病发病率呈动态变化,4-8月份和10-12月为高发期。不同年龄或地区人群中CoxA16、其他肠道病毒和EV71感染率之间差异有统计学意义(χ^(2)_(年龄)=12.05,P=0.017;χ^(2) _(地区)=32.917,P<0.01),其他肠道病毒和CoxA16感染率最高,分别为95.83%和39.35%,而EV71为27.78%。结论2011-2019年甘孜州手足口病感染者以藏族、3岁以下幼儿及散居幼儿感染居多,且流行毒株以CoxA16和其他肠道病毒为主。需加强手足口病健康教育和对重点人群的流行病学监测,防止疫情的暴发与流行。

Objective To analyze the epidemiological and etiological characteristics of hand,foot,and mouth disease in Ganzi Tibetan Autonomous Prefecture,Sichuan Province from 2011-2019 in order to provide a reference for control of hand,foot,and mouth disease.Methods Real-time quantitative PCR was used to examine throat swabs from 345 patients suspected of having hand,foot,and mouth disease,and the epidemiological and etiological characteristics of hand,foot,and mouth disease were analyzed.Results Of 345 patients suspected of having hand,foot,and mouth disease,62.61%(216/345)tested positive according to PCR.The rate of infection was 66.44%in Tibetans and 33.33%in Han Chinese,and the rate of infection differed significantly(χ^(2) =17.129,P<0.05).The rate of infection differed significantly among age groups(χ^(2) =11.019,P<0.05).Infants age 3 and younger had the highest rate of infection(69.01%).The rate of infection among temple priests and farmers was 76.47%.The rate of infection was 71.18%in children living separately from their parents,58.57%in kindergarteners,and 43.84%in students.Differences in the rate of infection between groups were significant(χ^(2) =18.225,P<0.05).The incidence of hand,foot,and mouth disease in Ganzi from 2011-2019 changed dynamically.The incidence peaked from April-August and from October-December.In different age groups and districts,the rate of infection with CoxA16,EV71,or some other enterovirus differed significantly between groups(χ^(2) _(age)=12.05,P=0.017;χ^(2) _(district)=32.917,P<0.01).Some other enterovirus and CoxA16 accounted for the highest rate of infection(95.83%and 39.35%vs.27.78%for EV71).Conclusion Individuals infected with hand,foot,and mouth disease in Ganzi from 2011-2019 were mainly Tibetans,infants age 3 and younger,and children living separately from their parents.The prevalent strains causing the disease were mainly CoxA16 and some other enterovirus.Health education about hand,foot,and mouth disease needs to be enhanced and epidemiological surveillance of target populations needs to be enhanced to prevent outbreaks and epidemics.