2017-2019年南京市手足口病流行病学及病原学特征

Epidemiological and pathogenic characteristics of HFMD in Nanjing,2017-2019

目的分析2017-2019年南京地区手足口病(HFMD)的病原学检测结果及流行病学特征,了解近年来南京地区手足口病的流行情况。方法用实时荧光定量PCR法对疑似手足口病的咽拭子标本核酸进行肠道病毒通用和分型检测。用Excel 2007进行病例资料整理,SPSS 13.0进行数据分析。结果 2017-2019年共收检疑似手足口病例2 053例,检测到核酸阳性例数1 158例,阳性率为56.41%(1 158/2 053);2017-2019年发病率差别不大,2017年稍高。4-7月份为发病高峰(46.80%),患者以5岁以下幼托和散居儿童为主(80.92%),男性多于女性(1.4∶1)。进一步分型发现,普通病例主要由柯萨奇病毒A组(Cox A)6型和Cox A16型感染所致,重症型病例由肠道病毒71(EV71)型主导流行。结论 2017-2019年南京地区手足口病流行存在明显的季节、人群差异,需加强对低龄儿童等高危人群的疫苗接种。在持续监测的基础上,深入病原学研究,对其进行更好的防控和治疗。

Objective To analyze the laboratory results and epidemiological characteristics of hand foot mouth disease(HFMD)in Nanjing from 2017 to 2019,and to understand the prevalence of HFMD in Nanjing.Methods HFMD DNA in throat swabs were detected by Real-time fluorescent quantitative PCR.Excel 2007 spreadsheet was used for data processing and SPSS 13.0 for data analysis.Results 2 053 suspected HFMD cases were detected in 2017-2019 and 1 158 cases were positive,with the positive rate of 56.41%(1 158/2 053);the incidence was slightly higher in 2017 than 2018 and 2019.The peak of HFMD cases occurred from April to July(46.80%).Patients were mainly children under 5 years old in kindergartens and scattered children(80.92%).Most of the patients were more male than female(1.4∶1).Coxasckie virus A(Cox A)6 and Cox A16 were the common leading epidemic cases while enterovirus 71(EV71)was the dominant epidemic strain in severe cases and death cases.Conclusions From 2017 to 2019,there were obvious seasonal,demographic and regional differences in the prevalence of HFMD in Nanjing.Kindergartens and scattered children under 5 years old were the key population for HFMD prevention and control and need to be vaccinated.Regular monitoring of HFMD virus was needed for better prevention and treatment in the next season.