广元市手足口病非 EV-A71非CV-A16肠道病毒病原学构成及流行特征分析

目的 了解广元市手足口病非EV-A71非CV-A16肠道病毒病原构成及流行特征，为手足口病精准防控提供科学依据。方法 收集2016-2018年广元市手足口病监测资料，选取非EV-A71非CV-A16肠道病毒临床标本进行VP4-VP2区基因测序分型。结果 广元市2016-2018年共报告手足口病病例6302例，年均报告发病率78.56/10万。对1547例手足口病例进行了实验室检测，肠道病毒通用核酸阳性1137例，其中非EV-A71非CV-A16肠道病毒占62.80%，病原构成以CV-A6为主占86.21%，其次是CV-A10（8.62%）；流行季节主要在4-10月，三岁及以下儿童占86.69%，利州区病例占全部病例的37.82%。结论 非EV-A71非CV-A16肠道病毒是广元市近年来手足口病优势病原体，型别多样，构成以CV-A6 和CV-A10为主，呈季节性流行、全年散发态势，发病高峰与EV-A71、CV-A16有所区别。加强对非EV-A71非CV-A16肠道病毒的病原监测，了解地区内HFMD病原分布及变异情况，对手足口病疫情研判和防控策略制定意义重大。

Etiological composition and epidemiological characteristics of hand-foot-mouth disease caused by non-EV-A71 and non-CV-A16 enterovirus,Guangyuan City

Objective To understand the composition and epidemic characteristics of non-EV-A71 and non-CV-A16 enterovirus of hand-foot-mouth disease (HFMD) in Guangyuan City, so as to provide scientific basis for the accurate prevention and control of HFMD. Methods The monitoring data of HFMD in Guangyuan City from 2016 to 2018 were collected, and the clinical samples of non-EV-A71 and non-CV-A16 enterovirus were selected for vp4-vp2 gene sequencing and typing. Results In Guangyuan City from 2016 to 2018, a total of 6302 cases of HFMD cases were reported, the average annual reported incidence was 78.56/105. By the laboratory tests of 1547 cases of HFMD, 1137 cases were general intestinal virus nucleic acid positive, among which, non-EV-A71 and non-CV-A16 enterovirus accounted for 62.80%, pathogenic form was given priority to with CV-A6 (86.21%), followed by CV-A10 (8.62%). Mainly in the popular season April-October, children aged three and under accounted for 86.69%, and the Lizhou district cases accounted for 37.82% of all cases. Conclusion Non-EV-A71 non-CV-A16 enterovirus is the dominant pathogen of HFMD in Guangyuan City in recent years, with diverse types. The composition is dominated by CV-A6 and CV-A10, presenting a seasonal epidemic and annual distribution trend. The incidence peak is different from EV-A71 and CV-A16. Strengthening the surveillance of non-EV-A71 and non-CV-A16 intestinal diseases and understanding the distribution and variation of HFMD in the region are of great significance for the accurate prevention and control of hand-foot-mouth disease.