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2010－2022年甘肃省酒泉市手足口病病原学监测结果分析

Etiological surveillance results of hand, foot and mouth disease in Jiuquan, Gansu, 2010−2022

    摘要
  • 摘要:
    目的 了解甘肃省酒泉市2010—2022年手足口病（HFMD）病原学分布特征，为今后HFMD疫情防控工作提供科学依据。
    方法 采集2010—2022年酒泉市各县区HFMD临床诊断病例的咽拭子标本，采用实时荧光反转录聚合酶链式反应进行检测，肠道病毒通用型引物检测阳性标本再进行肠道病毒71型（EV71）、柯萨奇病毒A组16型（Cox A16）、柯萨奇病毒A组6型（Cox A6）、柯萨奇病毒A组10型（Cox A10）分型鉴定。
    结果 2010—2022年共检测HFMD标本1 639份，肠道病毒通用型引物检测阳性1 175份，阳性率为71.69%，不同年间肠道病毒病原型别构成差异有统计学意义（2010—2015年：χ2=88.119，P<0.05；2017—2022年，χ2=210.864，P<0.05）。 13年内总体以Cox A16为优势株，占35.23%，其次为其他肠道病毒（28.94%）；2016年以后Cox A6逐渐成为优势株。 全年均有发病，每年呈现2个流行高峰，首峰较高，集中于5—7月，次峰为9—11月。 各年龄组病例肠道病毒通用型引物检测阳性率差异无统计学意义（χ2=12.207，P=0.142），但各型别肠道病毒构成差异有统计学意义（χ2=59.532，P<0.05），其中EV71阳性病例在4～岁组病例中占比最高（21.96%），在3～岁组中占比最低（11.04%）；Cox A6阳性病例在≥9岁组病例中占比最高（34.00%），在8～岁组占比最低（9.68%）；Cox A10阳性病例在3～岁组病例中占比最高（1.95%）；Cox A16阳性病例在6～岁组病例中占比最高（46.07%），在2～岁组占比最低（27.59%）；其他肠道病毒阳性病例在2～岁组病例中占比最高（41.38%），在4～岁组占比最低（22.75%）。
    结论 酒泉市HFMD由多病原引起，不同年份优势肠道病毒型别不同，应加强其他肠道病毒分型鉴定，HFMD流行高峰期应加大监测预警、预防控制和宣传力度。

     

    Abstract:
    Objective To understand the etiological characteristics of hand, foot and mouth disease (HFMD) in Jiuquan, Gansu province, from 2010 to 2022 and provide evidences for the prevention and control of HFMD in the future.
    Methods Throat swabs of HFMD cases were collected from 2010 to 2020 for the detection of enterovirus nucleic acid by real-time reverse transcription-polymerase chain reaction. The positive samples were detected for enterovirus 71 (EV71), coxsackie virus A16 (Cox A16), coxsackie virus A6 (Cox A6) and coxsackie virus A10 (Cox A10) with general primers of enterovirus.
    Results A total of 1 639 samples of HFMD cases were tested from 2010 to 2022, and 1175 were positive for enterovirus nucleic acid, with a positive rate of 71.69%. There were significant differences in the annual composition of the pathogens (2010−2015: χ2=88.119, P<0.05, 2017−2021: χ2=210.864, P<0.05). In the past 13 years, Cox A16 was predominant, accounting for 35.23% of the total, followed by other enterovirus (28.94%). Cox A6 had gradually become predominant since 2016. The cases occurred all the year round, and two incidence peaks occurred each year, the first peak was during May-July, and the second peak (sub-peak) was during September-November. There were no significant differences in the positive rate of enterovirus detected with general primers in different age groups (χ2=12.207, P=0.142). However, there were significant differences in the composition of enterovirus types (χ2=59.532, P<0.05). The positive rate of EV71 was highest in 4-year-old group (21.96%) and lowest in 3-year-old group (11.04%). The positive rate of Cox A6 was highest in 9-year-old group (34.00%) and lowest in 8-year-old group (9.68%). The positive rate of Cox A10 was highest in 3-year-old group (1.95%). The positive rate of Cox A16 was highest in 6-year-old group (46.07%) and lowest in 2-year-old group (27.59%). The positive rate of other enterovirus was highest in 2-year-old group (41.38%) and lowest in 4-year-old group (22.75%).
    Conclusion HFMD was caused by multi pathogens in Jiuquan, and the predominant pathogen varied with year. The typing and identification of other enterovirus should be strengthened. The HFMD surveillance, early warning, prevention, control and health education should be strengthened during May-July and September-November every year.

     

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