2017—2022年郑州市手足口病病原学监测结果分析

Analysis of etiological surveillance results of hand,foot and mouth disease in Zhengzhou from 2017 to 2022

目的了解2017—2022年郑州市手足口病病原谱的变化及其分布特征,为手足口病控制提供资料依据。方法收集2017—2022年郑州市疾病预防控制中心病毒实验室的手足口病病例的核酸检测结果及病例资料,采用描述性统计学方法分析其病原学特征,以卡方检验比较率的差异,趋势分析采用趋势χ^(2)检验,以P<0.05为差异有统计学意义。结果2017—2022年郑州市疾病预防控制中心病毒实验室收检了2825份医疗机构采集的手足口病病例标本,检出阳性1714份,检出阳性率60.67%。CV-A16和CV-A6交替成为郑州市手足口病流行的优势流行毒株,其他EV占11.96%,连续3年未检出EV71毒株,2019年开始郑州市重症手足口病病例呈断崖式下降。不同月份病原学检测阳性率差异有统计学意义(χ^(2)=156.053,P<0.001),不同性别病原学检测阳性率差异无统计学意义(χ^(2)=0.007,P=0.933),3岁~组检出率有增长趋势(趋势χ^(2)=4.773,P=0.029),托幼儿童检出率有增长趋势(趋势χ^(2)=328.145,P<0.001),不同地区送检标本的阳性率差异有统计学意义(χ^(2)=74.249,P<0.001)。结论2017—2022年郑州市手足口病病原谱变化明显,个别地区送检标本的阳性率低;应提高手足口病例标本的采样质量,增加检出效率,扩大病原谱的监测范围,积极开展流行病学调查,为郑州市手足口病防控提供参考。

Objective To understand the changes of pathogenic spectrum and distribution characteristics of hand,foot and mouth disease(HFMD)in Zhengzhou city of Henan province from2017 to 2022,and provide evidence for HFMD prevention and control.Methods The results of nucleic acid detection and data of HFMD cases were collected from the virus laboratory of Zhengzhou municipal center for disease control and prevention from2017 to 2022 were collected.The etiological characteristics were analyzed with descriptive epidemiology methods.The differences of incidences were compared with chi-square test,and the trend of incidences was tested with trend chi-square test.The differences were statistical significant if P<0.05.Results There were 2825 samples of HFMD cases collected from medical institutions and tested by the virus laboratory of Zhengzhou municipal center for disease control and prevention from2017 to 2022.There were 1714 positive samples,with the positive rate of 60.67%.The strains of CV-A16 and CV-A6 alternately became the dominant strains of HFMD in Zhengzhou city.Other EV strain accounted for 11.96%.EV71 strain was not detected during 3 consecutive years.The number of cases with severe HFMD fell off a cliff in Zhengzhou city since 2019.There was statistical difference in positive rates of etiological test in different months(χ^(2)=156.053,P<0.001),and there was no statistical difference between the positive rates of etiological test of genders(χ^(2)=0.007,P=0.933).The detection rates showed increasing trend in age group of 3 years(trendχ^(2)=4.773,P=0.029)and in the children of kindergartens(trendχ^(2)=328.145,P<0.001).There were statistical differences in the positivity rates of the samples sent from different districts(χ^(2)=74.249,P<0.001).Conclusions The pathogenic spectrum of HFMD obviously changed in Zhengzhou city from2017 to 2022.The positive rates of samples sent by several districts are low.The quality of sampling should be improved.The detection efficiency should be enhanced.The monitoring range of pathogen spectrum should be expanded.The epidemiological investigation should be actively carried out.All of these could provide reference for HFMD prevention and control in Zhengzhou city.