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目的分析2010年6月—2014年5月甘肃省天水市发热伴出疹症候群部分病原谱及流行病学特征,为其防控和临床诊疗提供科学依据。方法采集2010—2014年天水市2所哨点医院符合发热伴出疹病例定义患者的标本送至实验室,用RT-PCR和Real-time PCR法检测水痘—带状疱疹病毒、肠道病毒、麻疹病毒和风疹病毒,并用描述流行病学方法分析监测结果。结果 1 221例标本中检出阳性407例,阳性率33.33%,病原谱构成前三位为水痘—带状疱疹病毒(50.12%)、肠道病毒(41.03%)和风疹病毒(8.35%);6个年龄组(0岁~、3岁~、7岁~、15岁~、25岁~和60岁~)总阳性率差异有统计学意义(χ2=23.88,P<0.05);不同年龄组病原谱构成不同,0岁~组、3岁~组以EV71病毒为主,7岁~以上组以水痘—带状疱疹病毒为主,60岁~组阳性率最高72.22%;发病以托幼儿童(28.26%)、大学生(26.54%)和散居儿童(25.06%)为主;全年均有病例报告,病原体阳性率无明显季节规律。结论天水市发热伴出疹症候群病原体以水痘—带状疱疹病毒和肠道病毒为主,婴幼儿和学龄前儿童是防控的重点人群;加快研制肠道病毒疫苗,提高水痘和肠道病毒疫苗的接种率是防控发热伴出疹症候群传染病的关键措施。
Objective To analyze the epidemiological and epidemiological characteristics of fever and rash syndrome in Tianshui City, Gansu Province from June 2010 to May 2014 and provide a scientific basis for their prevention and control and clinical diagnosis and treatment. Methods Specimens from patients with fever and rash in 2 sentinel hospitals in Tianshui City from 2010 to 2014 were collected and sent to the laboratory for detection of varicella-zoster virus, enterovirus, Measles virus and rubella virus, and descriptive epidemiological analysis of monitoring results. Results A total of 407 positive samples were detected in 221 specimens, the positive rate was 33.33%. The top three pathogenic strains were varicella - zoster virus (50.12%), enterovirus (41.03%) and rubella virus (8.35%). The total positive rate of 6 age groups (0 years old, 3 years old, 7 years old, 15 years old, 25 years old and 60 years old) was statistically significant (χ2 = 23.88, P <0.05) The composition of the pathogenic spectrum is different. The majority of EV71 viruses were in group 0 and 3 years old. The majority of cases were in chickenpox and herpes zoster virus in the age group of 7 years and older. The highest positive rate was 72.22% in group 60 and 60 years old. (28.26%), college students (26.54%) and scattered children (25.06%). There are all the cases reported in the whole year, and there is no obvious seasonal pattern of pathogen positive rate. Conclusion The main pathogens of fever and rash syndrome in Tianshui are chickenpox-herpes zoster virus and enterovirus, and infants and preschool children are the key population for prevention and control. The vaccine for intestinal virus should be developed rapidly and the chickenpox and enterovirus vaccine should be increased The vaccination rate is a key measure to prevent fever and rash syndrome.