2016—2020年西安市手足口病中柯萨奇病毒A组6型感染的流行特征

Epidemiological characteristics of hand,foot and mouth disease cases caused by coxsackievirus group A type 6 in Xi’an city,2016-2020

目的了解2016—2020年西安市手足口病(hand,foot and mouth disease,HFMD)中柯萨奇病毒A组6型(coxsackievirus group A type 6,CV-A6)的流行病学特征,为HFMD防控提供科学依据。方法Real-time RT-PCR方法检测肠道病毒(enterovirus,EV),从传染病报告信息管理系统中获取病例的个案资料,采用描述性流行病学方法分析CV-A6感染HFMD的流行特征,Excel 2007和SPSS 18.0软件进行统计学分析。结果2016—2020年在4034例HFMD病例中,肠道病毒A组71型(enterovirus group A type 71,EV-A71)、柯萨奇病毒A组16型(coxsackievirus group A type 16,CV-A16)和其他EV的检出率分别为17.85%(720/4034)、23.92%(965/4034)和47.79%(1928/4034)。随机抽取2571例HFMD病例,其中其他EV阳性1268例,CV-A6在HFMD病例中的检出率为34.73%(893/2571),CV-A6在其他EV阳性病例中的构成比为70.43%(893/1268)。CV-A6感染HFMD的男女性别比为1.47∶1,≤5岁患儿占到所有病例的95.18%,发病高峰集中在4~6月份。CV-A6感染HFMD与EV-A71和CV-A16感染HFMD相比较,在临床分型上差异有统计学意义(χ^(2)=139.55,P<0.001),在年龄(F=2.74,P=0.065)和性别比(χ^(2)=2.43,P=0.297)上差异没有统计学意义。结论2016—2020年西安市HFMD的优势病原是其他EV,其中CV-A6在其他EV阳性病例中的检出率最高,应开展HFMD多种病原检测,加强CV-A6感染HFMD的防控。

Objective To characterize the epidemiology of hand,foot and mouth disease(HFMD)cases caused by coxsackievirus group A type 6(CV-A6)in Xi’an from 2016 to 2020 and provide evidence for the prevention and control of HFMD.Methods The enterovirus(EV)types were identified using real-time RT-PCR.The data of HFMD cases were collected from the National Notifiable Infectious Diseases Reporting System of China Center for Disease Control and Prevention.Descriptive epidemiological method were used to analyze the distributions and the data were statistically analyzed with Excel 2007 and SPSS 18.0.Results In the 4034 HFMD cases,17.85% had enterovirus group A type 71(EV-A71)infections,23.92% had coxsackievirus group A type 16(CV-A16)infections,and 47.79% had other EV infections.2571 HFMD cases were randomly selected,including 1268 other EV positive cases.The detection rate of CV-A6 in HFMD cases was 34.73%(893/2571),and the constituent ratio of CV-A6 in other EV positive cases was 70.43%(893/1268).The cases mainly occurred in children aged≤5 years(95.18%),more boys were affected than girls(1.47∶1).HFMD caused by CV-A6 was concentrated in April to June.Compared with EV-A71 and CV-A16,the clinical classification had significant difference in CV-A6 group(χ^(2)=139.55,P<0.001),but the ratio of sex and age-group had no significant difference(F=2.74,P=0.065;χ^(2)=2.43,P=0.297).Conclusions The predominant pathogen of HFMD in Xi’an from 2016 to 2020 were other EV,among which CV-A6 accounted for the highest proportion in other EV positive cases.It is necessary to strengthen the prevention and control of HFMD caused by CV-A6 and carry out the surveillance for various pathogens of HFMD.