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山东大学学报 (医学版) ›› 2019, Vol. 57 ›› Issue (11): 90-97.doi: 10.6040/j.issn.1671-7554.0.2019.558

• 公共卫生与管理学 • 上一篇    下一篇

济南市2012~2017年手足口病肠道病毒谱变化及流行特征

关恒云,王春荣,刘岚铮,杨国樑,赵怀龙,孙洁,成洪旗   

  1. 济南市疾病预防控制中心1.病毒性疾病检验所;2.细菌性疾病检验所, 山东 济南 250021
  • 发布日期:2022-09-27
  • 通讯作者: 刘岚铮. E-mail: jncdcllz@jn.shandong.cn
  • 基金资助:
    山东省医药卫生科技发展计划(2016WS0116);山东省医药卫生科技发展计划(2017WS529)

Changes of enterovirus spectrum and epidemiological characteristics of hand, foot and mouth disease in Jinan, China, 2012-2017

GUAN Hengyun, WANG Chunrong, LIU Lanzheng, YANG Guoliang, ZHAO Huailong, SUN Jie, CHENG Hongqi   

  1. 1. Viral Disease Inspection Laboratory;
    2. Bacterial Disease Inspection Laboratory, Jinan Center for Disease Control and Prevention, Jinan 250021, Shandong, China
  • Published:2022-09-27

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摘要： 目的 阐明济南市手足口病肠道病毒病原谱的构成及变化,探索不同肠道病毒类型的流行特征。 方法 收集2012年1月~2017年12月济南市手足口病标本4 929例,采用实时荧光定量逆转录-聚合酶链反应(RT-PCR)方法检测EV-A71、柯萨奇病毒A组16型(CV-A16)、柯萨奇病毒A组6型(CV-A6)和柯萨奇病毒A组10型(CV-A10);对肠道病毒通用(PE)阳性而未明确分型标本采用巢式RT-PCR方法,扩增肠道病毒5'-非翻译区(5'-UTR),经核苷酸序列测定明确肠道病毒类型。 结果 4 929例标本中共检出27种肠道病毒类型,除EV-A71、CV-A16、CV-A6和CV-A10外,柯萨奇病毒A组(CV-A2、4、5、9、12、13、21、22、24)、柯萨奇病毒B组(CV-B1~5)、埃可病毒(E3、6、7、9、11、18、24、25、30)均有检出。轻型病例肠道病毒感染率居前4位的是CV-A16(29.03%)、EV-A71(25.67%)、CV-A6(17.58%)和CV-A10(3.10%),重症病例为EV-A71(77.64%)、CV-A16(5.59%)、CV-A6(1.86%)和CV-A10(1.24%)。CV-A6和CV-A10感染者的发病年龄较EV-A71和CV-A16感染者略小,分别为(3.02±2.43)岁、(2.87±1.67)岁、(3.29±2.34)岁和(3.36±2.18)岁,差异有统计学意义(F=3.659,P=0.003)。流行季节研究显示,EV-A71和CV-A16发病高峰为第2或4季度,CV-A6好发于6~12月份,CV-A10病例6~8月份发病较多。平阴县和章丘区肠道病毒阳性检出率较高,分别为93.49%和91.99%。 结论 济南市手足口病肠道病毒谱以EV-A71、CV-A16、CV-A6和CV-A10为优势型别,27种肠道病毒共存。常年监测非EV-A71非CV-A16肠道病毒的流行特征,及时掌握肠道病毒谱变化,有助于及时完善手足口病疫情的防控措施。

关键词: 手足口病, 肠道病毒, 病原谱, 流行特征

Abstract: Objective To clarify the composition and changes of enterovirus spectrum in hand, foot and mouth disease in Jinan, China, from Jan. 2012 to Dec. 2017, further to analyze the epidemiological characteristics of different types of enterovirus. Methods A total of 4 929 specimens were collected from clinically diagnosed hand, foot and mouth disease cases in Jinan from 2012 to 2017. All specimens were detected for Enterovirus A71(EV-A71), Coxsackievirus(CV)-A16, CV-A6 and CV-A10 by real-time reverse transcription-polymerase chain reaction(RT-PCR). For unclassified specimens, reverse transcription nested PCR based on the 5'-untranslated region(5'-UTR)sequence was performed and the types of enterovirus were determined by nucleotide sequencing. Results A total of 27 types of enterovirus were identified in 4 929 specimens, including not only EV-A71, CV-A16, CV-A6 and CV-A10, but also CV-A2, 4, 5, 9, 12, 13, 21, 22, 24, CV-B1-5 and E3, 6, 7, 9, 11, 18, 24, 25, 30. The constituent ratios were different between 山 东 大 学 学 报 (医 学 版)57卷11期 -关恒云,等.济南市2012~2017年手足口病肠道病毒谱变化及流行特征 \=-mild and severe cases. The top four types of enterovirus for mile cases were CV-A16(29.03%), EV-A71(25.67%), CV-A6(17.58%)and CV-A10(3.10%), and for severe cases were EV-A71(77.64%), CV-A16(5.59%), CV-A6(1.86%)and CV-A10(1.24%). The cases with CV-A6 and CV-A10 infections were younger than EV-A71 and CV-A16 infections(F=3.659, P=0.003), and they were(3.02±2.43),(2.87±1.67),(3.29±2.34)and(3.36±2.18)years, respectively. The incidence peak of EV-A71 and CV-A16 appeared usually in the second or fourth quarter, CV-A6 mostly occurred from June to December, and CV-A10 from June to August. The positive detection rate of enteroviruses was higher in Pingyin county and Zhangqiu district(93.49% and 91.99%, respectively). Conclusion EV-A71, CV-A16, CV-A6 and CV-A10 were the dominant types of enteroviruses associated with hand, foot and mouth disease in Jinan, and 27 types of enteroviruses coexisted from 2012 to 2017. The epidemiological characteristics of non-EV-A71 and non-CV-A16 enterovirus should be monitored year-by-year. To clarify the changes of enterovirus spectrum clearly will help health authorities to early provide prevention and control measures for epidemics.

Key words: Hand, foot and mouth disease, Enterovirus, Pathogenic spectrum, Epidemic characteristic

中图分类号: 

  • R115
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