萍乡市健康人群手足口病肠道病毒隐性感染状况分析

摘要:目的　分析萍乡市健康人群手足口病肠道病毒隐性感染的状况，为萍乡市手足口病防控提供科学依据。方法　收集668名健康儿童及112名孕妇血清进行HEV71中和抗体检测，同时采集总计100名幼教人员、幼儿及儿童家长的手及咽部涂抹样，进行手足口病肠道病毒核酸检测（包括PE、EV71 和CoxA16）。结果　668名儿童中，HEV71中和抗体阳性率为56.0%，平均几何滴度为1∶16.34，不同年龄组儿童抗体阳性率有统计学差异（χ2＝51.12，P＜0.05），各年龄组的中和抗体构成不一致（χ2＝154.39，P＜0.05）。112名孕妇，阳性率为92.9%，平均几何滴度为1∶29.89。100名健康人群检出肠道病毒核酸阳性率为18.0%，幼教人员、儿童家长、儿童3组人群的阳性率有统计学差异（χ2＝12.78，P＜0.05），手部涂抹样和咽拭子的检出阳性率无统计学差异（χ2＝2.85，P＞0.05）。结论　≤3岁儿童是手足口病防控的重点人群，肠道病毒感染状况对儿童手足口病的流行有一定的影响，儿童和成人勤洗手、室内常通风是防控手足口病的重要措施。建议儿童在7月龄开始接种EV71疫苗。

Analysis on epidemic situation of recessive infection of HFMD in healthy population in Pingxiang

Abstract: Objective This work aimed to understand the epidemic situation of recessive infection of HFMD in healthy population in Pingxiang, so as to provide scientific basis for HFMD prevention and control. Methods 780 serum specimens were collected from 668 healthy children and 112 pregnant women. HEV71 antibodies were detected by using neutralization test. Hand daub and throat swab samples were collected from a total of 100 kindergartens, children and children's parents. The viral RNA from these samples were extracted and amplified to detect nucleic acid of enterovirus 71, CoxA16 and other enterovirus by utilizing the technique of RT-PCR. Results Among 668 children, the positive rate of HEV71 neutralizing antibody was 56%, and the geometric mean titer was 1: 16.34. The positive rate was different in different age groups of children with statistical significance, and the neutralizing antibody component in various age groups was also different. The positive rate among 112 pregnant women was 92.9%, and the geometric mean titer was 1: 29.89. The detection rate of enterovirus nucleic acid in 100 healthy people was 18.0%. There were significant differences in the positive rate between kindergarteners, children and children's parents, but no significant differences between hand daub and throat swab samples. Conclusion Children of 3 years old or less were the focus group for HFMD prevention and control. Intestinal virus infection had certain influence on children's HFMD. Frequent hand washing and indoor ventilation were important measures for HFMD prevention and control. EV71 vaccine is suggested for children of 7 month age.