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目的探讨2014年杭州地区手足口病的流行病学特征及病原学特点,以及手足口病发病率及病原体时间分布与气象因素的关系。方法对2014年杭州地区手足口病的临床病例进行流行病学特点分析,同时利用实时荧光定量聚合酶链反应检测临床获得的咽拭子标本,对其进行病毒核酸检测;对手足口病病例及病原体的时间聚集性与当地的气象情况进行相关性分析。结果 2014年杭州地区共临床诊断手足口病病例6 640例,男女比例为1.44∶1,年龄以1~3岁为主,以本地区散居儿童居多;对临床诊断的住院病例2 370份标本检测结果显示:柯萨奇病毒A16型(CA16)242例,阳性率为10.2%,肠道病毒71型(EV71)936例,阳性率为39.5%,其他肠道病毒1 192例,阳性率为50.3%。手足口病病例时间聚集以5~7月份为高峰,并且手足口病高峰期(5~7月)病原学以EV71为主;手足口病发病率及病原体分布与平均气温、降雨量和相对湿度均呈正相关(P均<0.05);且EV71主要分布在平均气温高、降雨量大和相对湿度高的月份,而肠道病毒通用型主要分布在平均气温较低、降雨量少和相对湿度低的月份。结论杭州地区2014年手足口病仍以1~3岁散居男童为主,病原学以EV71及肠道病毒通用型为主;手足口病病例时间聚集以5~7月份为主。手足口病发病率及病原体分布情况与平均气温、降雨量及相对湿度呈密切相关。
Objective To investigate the epidemiological and etiological characteristics of HFMD in Hangzhou in 2014 and the relationship between the incidence of HFMD and the distribution of pathogens and meteorological factors. Methods The epidemiological characteristics of HFMD cases in Hangzhou area in 2014 were analyzed. The clinical samples of throat swabs were detected by real-time fluorescence quantitative polymerase chain reaction (PCR) Correlation analysis of time aggregation of pathogens and local weather conditions. Results A total of 6 640 cases of HFMD were diagnosed in Hangzhou in 2014, with a male-to-female ratio of 1.44:1. The majority of children were aged 1-3 years old. Most of the children were scattered in the area. A total of 2 370 samples of in-hospital diagnosed cases were detected The results showed that 242 cases of Coxsackie virus A16 type (CA16) had a positive rate of 10.2%, 936 cases of enterovirus 71 (EV71), with a positive rate of 39.5% and 1 192 other enteroviruses with a positive rate of 50.3 %. HFMD cases gathered in time from May to July as the peak, and the peak of hand-foot-mouth disease (May-July) was mainly EV71; HFMD and pathogen distribution and mean temperature, rainfall and relative humidity (P <0.05). EV71 mainly distributed in months with high average temperature, heavy rainfall and high relative humidity. However, the general patterns of enterovirus were mainly distributed in the areas of lower average temperature, less rainfall and lower relative humidity month. Conclusion Hand, foot and mouth disease in Hangzhou in 2014 is still dominated by scattered diarrhea boys aged 1-3 years. The etiological agents are mainly EV71 and intestine virus. The cases of hand-foot-mouth disease mainly accumulate in time from May to July. The incidence of hand-foot-mouth disease and the distribution of pathogens are closely related to the average temperature, rainfall and relative humidity.