2009—2016年上海市闵行区手足口病病原学监测及流行病学特征分析

发布时间：2018-03-16 05:23

  本文选题：手足口病　切入点：肠道病毒型　出处：《复旦学报(医学版)》2017年05期 　论文类型：期刊论文

【摘要】：目的对2009—2016年上海市手足口病(hand,foot and mouth disease,HFMD)哨点医院——复旦大学附属儿科医院及闵行区辖区社区卫生服务中心送检的手足口病病例标本进行实验室检测分析,探讨手足口病在本地区的病原学构成及流行病学特征,为手足口病的综合防治提供依据。方法收集2009—2016年复旦大学附属儿科医院及社区卫生服务中心送检的手足口病病例咽拭、粪便、肛拭标本,应用real-time RT-PCR技术检测肠道病毒通用型(Echo viruses,EV)、肠道病毒71型(EV71)、柯萨奇病毒A组16型(Coxsackie virus A16,CVA16)、柯萨奇病毒A组6型(CVA6)、柯萨奇病毒A组10型(CVA10),并分析病原体分布特征。结果共收集到手足口病病例3 744例,病原学检测发现3 176例肠道病毒检测阳性,阳性检出率高达84.83%。其中EV71和CVA16分别占64.45%和15.77%,其次是CVA6和其他肠道病毒,分别占9.23%和8.78%,CVA10检出率仅0.76%,主要病原体为EV71病毒。不同年份和不同季节的优势毒株呈现动态变化;2009年以EV71和CVA16共同流行为主;2010—2011年以EV71流行为主;2012年呈现EV71和CVA16共同流行趋势,以EV71为主;2013年以EV71和其他EV共同流行为主;2014年之后CVA6逐渐增多,至2015和2016年主要以CVA6流行为主;特别是2016年,CVA6所占比例范围高达40.55%。CVA10呈零星散发趋势,占比极低。病例人群男性高于女性(1.68∶1),主要发病年龄为5岁以下的婴幼儿,病例集中在1~3岁低幼年龄组,手足口病发病高峰主要集中在4~7月,其次是9~11月。结论手足口病主要发病季节呈现夏季和秋冬季的双峰流行模式;多发于5岁以下儿童;男性发病率高于女性;不同年份和不同季节的优势毒株呈现动态变化,其流行具有明显的年龄和季节性特征。
[Abstract]:Objective to detect and analyze the hand foot and mouth disease (HFMD) case samples from Shanghai Hand-foot and mouth Disease Sentinel Hospital, affiliated Pediatrics Hospital of Fudan University and the Community Health Service Center of Minhang District from 2009 to 2016. To explore the etiological composition and epidemiological characteristics of HFMD in this area, and to provide the basis for the comprehensive prevention and treatment of HFMD. Methods the pharyngeal swabs of HFMD cases from 2009 to 2016 were collected from Pediatrics Hospital and Community Health Service Center of Fudan University. Faeces, anal swabs, Real-time RT-PCR technique was used to detect enterovirus Echo virus EVN, enterovirus 71 EV71, Coxsackie virus A16, Coxsackie virus A16, Coxsackie virus A16, Coxsackie A 6, Coxsackie virus A 6, Coxsackie virus A 10 CVA10 and to analyze the distribution of pathogens. 3,744 cases of hand, foot and mouth disease were collected, Pathogenic examination showed that 3 176 cases of enterovirus were positive, the positive rate was as high as 84.83%, of which EV71 and CVA16 accounted for 64.45% and 15.77 respectively, followed by CVA6 and other enterovirus. The positive rate of CVA10 was only 0.76% in 9.23% and 8.78%, respectively. The main pathogen was EV71 virus. The dominant strains in different years and seasons showed dynamic changes; in 2009, the common epidemic of EV71 and CVA16 was mainly EV71 in 2010-2011; in 2012, EV71 and CVA16 were the same epidemic trend. In 2013, EV71 and other EV were the main epidemic. After 2014, the prevalence of CVA6 increased gradually, and by 2015 and 2016, the prevalence of CVA6 was mainly CVA6. Especially, the proportion of CVA6 was as high as 40.55%. CVA10 showed sporadic tendency. The incidence of HFMD in male was higher than that in female (1.68: 1). The incidence of HFMD was mainly in the age group of primary-age aged 1 ~ 3 years. The incidence peak of HFMD was mainly from 4 to July, and the incidence of HFMD was mainly in the age group of 1 ~ 3 years old. Conclusion the prevalence pattern of HFMD in summer and autumn and winter is more than that in children under 5 years of age, the incidence of HFMD in males is higher than that in females, and the dominant strains of HFMD in different years and seasons show dynamic changes. Its prevalence has obvious age and seasonal characteristics.
【作者单位】： 上海市闵行区疾病预防控制中心;
【基金】：上海市第四轮公共卫生三年行动计划高端海外研修团队计划(GWTD2015S05) 上海市研究生教育创新计划~~
【分类号】：R181.3;R512.5
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本文编号：1618526