2017-2020年河南省安阳市手足口病病原监测及流行特征分析

Pathogen surveillance and epidemiological characteristics of hand-foot-mouth disease in Anyang of Henan in 2017-2020

目的 了解安阳市手足口病(hand-foot-mouth disease, HFMD)病原变化趋势和流行特征,为 HFMD 防控工作提供科学依据。方法 对 2017-2020 年安阳市 1 581 份 HFMD 病例样本进行 Real time RT-PCR 检测,在病原谱构成、人群分布、地区分布等方面进行统计学分析。结果 1 581 份粪便标本中肠道病毒的阳性率为 91.40%,主要检出的病原体有 CVA6 (42.91%)、CVA16 (31.63%)、EV71 (19.72%)、和 CVA10 (1.87%)。5 岁以下儿童阳性占比为 92.73%,其中 1~2岁年龄组最多(34.53%),不同年龄组阳性率差异有统计学意义(χ^(2)= 2.113,P=0.043),男、女阳性率差异有统计学意义(χ^(2)=1.936,P=0.048)。除 2020 年外,其他年份发病高峰期集中在 5-7 月份。阳性率位于前三的区县为北关区、文峰区、殷都区三个主城区。结论 2017-2020 年安阳市 HFMD 病原谱构成发生改变,CVA6 成为优势毒株,HFMD 发病具有明显的人群、时间和地区分布特征。

Objective To understand the pathogen change trend and epidemiological characteristics of hand-foot -and -mouth disease (HFMD) in Anyang city, and provide scientific evidence for the prevention and control of HFMD. Methods The samples collected from 1 581 HFMD cases in Anyang city from 2017 to 2020 were tested by real time RT -PCR. The composition of pathogen spectrum, population distribution and regional distribution were statistically analyzed. Results The positive rate of enterovirus in 1 581 fecal samples was 91.40%. The main pathogens identified were CVA6 (42.91%), CVA16 (31.63%), EV71(19.72%), and CVA10 (1.87%). The positive rate among children under 5 years old was 92.73%, of which it was the most among1-2-year-old group (34.53%). There was significant difference in the positive rates between different age groups (χ^(2)=2.113, P=0.043), and there was significant difference in the positive rate between men and women (χ^(2)=1.936, P=0.048). In the period except for 2020, the peak incidence was concentrated from May to July. The top three districts/counties with high positive rates included Beiguan district, Wenfeng district and Yindu district. Conclusion The pathogen spectrum of HFMD has changed in Anyang city from 2017 to 2020. CVA6 has become the dominant strain. The incidence of HFMD has obvious characteristics of population, time and regional distribution.