2016年北京市疱疹性咽峡炎流行情况及病原体构成分析

目的 了解北京市疱疹性咽峡炎的流行情况及病原体构成,为该病的预防与控制提供参考.方法 收集2016年北京市15个区监测医院中首次就诊的10岁以下疱疹性咽峡炎和手足口病病例基本信息及临床表现,并采集咽拭子进行病原体检测.结果 本研究共纳入符合条件的疱疹性咽峡炎病例744例,其中5岁及以下病例占86.83%,性别比(男:女)为1.23:1;手足口病病例1935例,5岁及以下病例占88.94%,性别比为1.40:1.两类病例的标本采集高峰都集中在5—7月.疱疹性咽峡炎的发病至诊断时间间隔为(1.08±1.32)d,手足口病的发病至诊断时间间隔为(1.12±1.33)d,差异无统计学意义(t=0.614,P=0.336).疱疹性咽峡炎和手足口病病例中发热的比例分别为67.20%和45.94%(x2=96.158,P<0.001).诊断为疱疹性咽峡炎的病例全部为轻症,而手足口病病例有21例(1.09%)发展为重症.肠道病毒核酸阳性病例分别为401例(53.90%)和1362例(70.39%)(x2=64.640,P<0.001).疱疹性咽峡炎的病原体主要为其他肠道病毒(62.59%),而手足口病的病原体主要为CA16(44.93%).结论 疱疹性咽峡炎与手足口病发病人群近似,均为5岁以下的儿童,男性略高于女性,发病高峰均为5—7月.引起两者发病的病原体构成不同,临床症状也有所区别,疱疹性咽峡炎的预后较好.EV71、CA16、CA6和其他肠道病毒等都可引起疱疹性咽峡炎和手足口病,所以应重视疱疹性咽峡炎,并参考手足口病进行病例隔离和环境消毒.

The epidemiological characteristics of herpangina and its pathogen distribution in Beijing, 2016

Objective To explore the epidemiological characteristics of herpangina and its pathogen distribution in Beijing, so as to provide reference for the prevention and control of herpangina. Methods The initial diagnosed cases of herpangina and hand-foot-mouth disease (HFMD) were obtained from the HFMD surveillance hospitals in fifteen districts of Beijing in 2016. Personal profiles and clinical manifestations were collected, and the throat swabs were tested after sampling. Results There were 744 herpangina cases included, of which 86.83% were under 5 years old, and the male-to-female ratio was 1.23:1. There were 1935 HFMD cases of which 88.94% were under 5 years-old, and the male-to-female ratio was 1.40:1. Most cases were included during May to July. Among herpangina cases, the time interval between onset and diagnosis was in (1.08±1.32) days; while in HFMD cases, it was (1.12±1.33) days (t=0.614, P=0.336). The proportion of fever in herpangina was higher than that in HFMD (67.20% vs 45.94%, x2 = 96.158, P<0.001). All herpangina cases were in mild medical condition, whereas 21 (1.09%) cases of HFMD developed into severity. A total of 401 (53.90%) herpangina and 1362 (70.39%) HFMD cases were enterovirus positive (x2=64.640, P<0.001). The highest proportion of pathogen in herpangina was non-EV71, non-CA16, and non-CA6 enterovirus (62.59%), while the highest proportion in HFMD was CA16 (44.93%). Conclusions A large proportion of herpangina and HFMD were children under 5 years olds, and males lightly outnumbered the females. The case numbers of herpangina and HFMD peaked during May and July. The distribution of pathogen differs in herpangina and HFMD cases, and the clinical manifestations vary accordingly. Herpangina was good in prognosis. Enteroviruses can cause both herpangina and HFMD. The isolation of herpangina cases and environmental disinfection can therefore refer to the controning guidance and measures of HFMD.