2010-2017年上海市浦东新区发热伴出疹性疾病病原学分析

Study on the etiology of rash and fever illness in Pudong New Area of Shanghai from 2010 to 2017

目的分析2010年1月~2017年12月浦东新区发热伴出疹性疾病(rash and fever illness, RFIs)的病原谱构成及流行特征,为RFIs防控提供科学依据。方法采用酶联免疫吸附法和实时荧光定量聚合酶链反应对2 381例临床标本进行肠道、麻疹、风疹等病毒的病原学检测,并进行统计分析。结果 2 381例样本中RFIs检测阳性1 633例(68.59%)。病原谱构成前4位病毒分别是肠道(52.54%)、麻疹(28.54%)、风疹(13.04%)、水痘-带状疱疹(3.37%)。男性风疹病原体检出率高于女性,差异有统计学意义(P=0.026)。年龄组分布中,肠道病毒集中在3~6岁年龄组,水痘-带状疱疹病毒集中在6~18岁年龄段,麻疹病毒、风疹病毒、登革热病毒、小DNA病毒集中在18岁以上年龄段,不同年龄组的病原体检出率差异均有统计学意义(均有P<0.05)。RFIs发病集中在春季(41.52%),冬季最少(15.00%),其中肠道、麻疹、风疹、登革热病毒在不同季节的病原体检出率差异有统计学意义(P<0.05)。结论肠道和麻疹病毒是本地RFIs感染的主要病原体,应长期监测RFIs病原体的活动水平。

Objective To investigate the pathogens spectrum and epidemiological characteristics of rash and fever illness(RFIs)from January 2010 to December 2017 in Pudong New Area,in order to provide scientific evidence for the prevention and control ofRFIs.Methods Enzyme-linked immunosorbent assay and real-time fluorescence quantitative polymerase chain reaction were used to detect the pathogens of enterovirus,measles virus,rubella virus and others from 2 831 clinical samples,and statistical analysis was performed.Results Pathogens were found in 1 633 samples in total,accounting for 68.59%.The top 4 viruses in the pathogen spectrum were enterovirus(52.54%),measles virus(28.54%),rubella virus(13.04%),and varicella-zoster virus(3.37%).There was significnat difference in the detection rate of rubella pathogens among patients of different genders(P=0.026).In the pathogen spectrum of infections of different age groups,the detection rate of enteroviruses at the age of 3-6 years was higher than that of other age groups.The detection rate of varicella-zoster virus at the age of 6-18 years old was higher than that of other age groups.The detection rate of virus including measles virus,rubella virus,dengue virus and small DNA virus in age of 18 and older was higher than that of other age groups.There was significant difference in the detection rate of pathogens in different age groups(all P<0.05).The incidence of RFIs was the highest in spring(41.52%)and the lowest in winter(15.00%).There was a statistical difference in the detection rate of enterovirus,measles,rubella and dengue virus in different seasons(P<0.05).Conclusions Enteroviruses and measles viruses are the main pathogens leading to RFIs in Pudong New Area,and the activity level of RFIs pathogens should be monitored for a long time.