论文部分内容阅读
目的了解浙江省奉化市手足口病患者及其密切接触者病原分布情况,分析2013-2014年手足口病疫情和病原学监测结果,为手足口病防控提供科学依据。方法每月采集手足口病患者5例及其15名密切接触者粪便标本检测肠道病毒,同时开展住院病例病原学监测,对2013-2014年病原学监测结果和手足口病疫情进行描述性流行病学分析。结果 2013-2014年奉化市手足口病发病率分别为225.99/10万和365.07/10万;街道发病率高于乡镇;发病率最高为1岁组。病例肠道病毒A组71型(EV71)、柯萨奇病毒A组16型(Cox A16)和其他肠道病毒阳性率分别为20.94%、20.42%和38.74%;2013年优势病毒为其他肠道病毒(占61.00%),2014年为Cox A16和EV71;EV71发病年龄大于其他肠道病毒(Z=-3.70,P=0.00);肠道病毒阳性病例和阴性病例的密切接触者阳性率分别为48.44%和18.75%,差异有统计学意义;不同病毒阳性病例的密切接触者其他肠道病毒阳性率在44.96%~48.15%之间,差异无统计学意义;病例与密切接触者肠道病毒以同型为主(Kappa值0.53);1~8岁密切接触者阳性率42.08%,12~66岁密切接触者阳性率31.73%,差异无统计学意义。结论奉化市手足口病处于高流行态势,流动人口密集地区高发。多种病毒流行,优势病毒处于变化中,流行特征与病原体有关,病原监测有助于采取适当的防控措施,必要时应对其他肠道病毒开展进一步分型。密切接触者带病毒率高,应关注密切接触者管理。
Objective To understand the pathogen distribution of HFMD in Fenghua City, Zhejiang Province and its close contacts, and to analyze the epidemiological and etiological monitoring results of HFMD in 2013-2014 so as to provide a scientific basis for prevention and control of HFMD. Methods A total of 5 cases of HFMD and 15 close contact stool specimens were collected to detect enterovirus every month. At the same time, etiological surveillance of inpatients was conducted. The etiological surveillance results and hand-foot-mouth disease epidemics in 2013-2014 were descriptively analyzed Disease analysis. Results The incidence rates of hand-foot-mouth disease in Fenghua from 2013 to 2014 were 225.99 / 100000 and 365.07 / 100000, respectively. The incidence of street disease was higher than that of township and the highest incidence was 1-year-old group. The positive rates of enterovirus 71 (EV71), Cox A16 and other enterovirus were 20.94%, 20.42% and 38.74%, respectively. In 2013, the predominant viruses were other intestinal (61.00%) were Cox A16 and EV71 in 2014. The age of onset of EV71 was higher than that of other enteroviruses (Z = -3.70, P = 0.00). The positive rates of close contacts between enterovirus positive and negative cases were 48.44% and 18.75%, respectively, the difference was statistically significant. The positive rates of other enteroviruses in close contact with different virus positive cases ranged from 44.96% to 48.15%, the difference was not statistically significant; cases and close contact with enterovirus The same type (Kappa value 0.53); 1 to 8 years of close contact with the positive rate of 42.08%, 12 to 66 years of close contact with a positive rate of 31.73%, the difference was not statistically significant. Conclusion Fenghua City HFMD is in a highly epidemic situation with high incidence of floating population. Prevalence of many viruses, the dominant virus is changing, the prevalence of pathogens and pathogenicity, pathogen monitoring help to take appropriate control measures, if necessary, to carry out further typing of other enteroviruses. Close contacts with high virus rates, should pay close attention to close contact management.