2019年深圳地区疱疹性咽峡炎流行病学及病原学监测研究

Epidemiological and etiological surveillance of herpangina in Shenzhen in 2019

目的对2019年深圳市疱疹性咽峡炎监测数据进行分析,阐述流行特征和病原学特点。方法收集123个病例的咽拭子、粪便和肛拭子样本共208份。通过实时荧光定量RT-PCR和半巢式RT-PCR结合测序分析对肠道病毒进行检测和分型。结果123个病例中位年龄2(1,3)岁,以5岁以下患儿为主(108/123,87.80%),1岁组患儿最多(35/123,28.46%)。5月和6月为发病高峰。口腔疱疹(110/123,89.43%)和发热(111/123,90.24%)为最主要的两种临床症状,发热患儿以高热最多(54/111,48.65%)。咽拭子与粪便的肠道病毒核酸检出率差异无统计学意义(P=0.754),二者检测结果具中等一致性(Kappa=0.589,P<0.01)。病例感染肠道病毒以CVA4(31/93,33.33%)、CVA6(18/93,19.35%)和CVA5(13/93,13.98%)为主。1—6月以CVA4感染为主,7—10月以CVA6为主。结论2019年深圳市疱疹性咽峡炎病例以5岁以下患儿为主,高热患儿比例高,全年存在一个发病高峰,病原体以CVA4、CVA6和CVA5为主。

Objective To analyze herpangina(HA)surveillance data in Shenzhen 2019,so as to describe the epidemiological characteristics and etiological features.Methods A total of 208 samples of pharyngeal swabs,stool and anal swabs were collected from 123 cases of HA.Enteroviruses were detected and genotyped by real time fluorescence quantitative RT-PCR and semi-nested RT-PCR with sequencing analysis.Results The median age of 123 cases was 2(1,3)years old.The patients under 5 years old were dominant(108/123,87.80%)with the largest number of patients in the 1-year-old group(35/123,28.46%).The peak of incidence was observed in May and June.Oral herpes(110/123,89.43%)and fever(111/123,90.24%)were the two most common clinical symptoms.High fever was the most common feature among pediatric patient with fever(54/111,48.65%).For the nucleic acid test for enteroviruses,the difference between the positive rates of pharyngeal swab and stool was not statistically significant(P=0.754)while the results of both samples were in consistent with moderate agreement(Kappa=0.589,P<0.01).The types of enteroviruses in the cases were mainly CVA4(31/93,33.33%),CVA6(18/93,19.35%)and CVA5(13/93,13.98%).From January to June,CVA4 was the predominant type of enterovirus and CVA-6 was dominant from July to October.Conclusions In 2019,HA cases in Shenzhen were predominant in children under 5 years,with a high proportion of high fever.There was one incidence peak throughout the year.The main pathogens were CVA4,CVA6 and CVA5.