2015-2017年南宁市手足口病病原学监测结果分析

目的 了解2015-2017年南宁市手足口病病原谱及其流行特征,为其防控提供科学的参考依据。方法 采用实时荧光定量PCR对2015-2017年南宁市采集的南宁市手足口病病例标本进行肠道病毒检测,并对病原学检测数据进行整理分析。结果 2015-2017年,共采集手足口病病例标本4 633例,阳性标本3 886例(83.88%)。其中EV71型、CoxA16型和他类型的EV的构成比分别为31.29%,14.59%,54.12%。南宁市全年均有手足口病病例报告,发病高峰期为每年的3-11月。每年手足口病病毒的型别特征各不相同。病毒核酸检测阳性病例以5岁以下儿童为主(96.29%),男性病例阳性检出率(85.49%)高于女性(80.97%)(x2=16.120, P ＜0.001)。1 899例重症患者标本和7例死亡病例标本中,重症病例EV71型阳性率为43.29%,其他肠道病毒阳性率为47.68%。死亡病例全部为EV71型。结论 南宁市手足口病病原谱变化多样,除了EV71和CoxA16型,还应加强对其他肠道病毒的检测。5岁以下儿童,特别是4岁以下的儿童是防控手足口病,防止病程进展为重症、死亡病例的重点关注的人群。

Surveillance of the Hand-foot-and-mouth-disease,Nanning,2015-2017

Objective To understand the epidemiological characteristics of hand-foot-and-month disease(HFMD)in Nanning city from 2015 to 2017,so as to provide evidence for the prevention and control.Methods Real-time polymerase chain reaction(RT-PCR)was used to detect HFMD virus in the specimens from the patients with HFMD in Nanning from 2015 to 2017.The data of etiology were then analyzed.Results 4 633 tested specimens were collected.The positive cases were 3 886 in total,and the positive rate was 83.88%,in which EV71 rate accounted for 31.29%,CoxA 16 rate accounted for 14.59%,other EV rate accounted for 54.12%.The HFMD cases were reported all year round,with a high incidence between March and November.The type of the pathogen of HFMD was different each year.HFMD virus infection mainly occurred in children under the age of 5.Male cases positive detection rate is higher than female cases(x2=16.120, P ＜0.001).Among 1 899 severe cases and 7 death cases,the positive rate of Enterovirus 71 and another enterovirus in the severe cases were 43.29% and 47.68%,respectively.And all death cases were associated with the EV71 type.Conclusion In addition to EV71 and CoxA16,detection of other enteroviruses should also be strengthened to grasp the epidemic rules of pathogens.Children under 5,particularly under 3,are the focus of the prevention and control of HFMD.