CAJ | 학술논문

目的分析2008-2011年宁波市手足口病流行特征.方法从疾病监测信息报告管理系统获取宁波市2008-2011年手足口病资料,运用描述流行病学方法进行分析.对粪便标本采用RT-PCR扩增基因序列测定,并利用生物学软件分析.结果 2008-2011年宁波市共报告手足口病病例37 524例,其中重症196例,死亡12例,年均发病率为145.26/10万,病死率为0.03％.＜5岁儿童占报告病例的95.89％,散居儿童占64.10％；各地区发病均处于较高水平,其中宁海、象山县为发病率最高的地区,发病高峰在4-7月,男性多于女性.实验室确诊2394例,肠道病毒(EV)71型是主要的病毒株,进化树分析表明宁波市手足口病EV71分离株属于C4a进化分支,其流行和传播存在多个传播链.Cox A16株同时包含Bla和Bib两条进化分支共同流行.健康儿童EV71中和抗体阳性率为53.48％,GMT为11.23(8.33 ～ 14.98)；Cox A16中和抗体阳性率为63.18％,GMT为12.61(6.70 ～ 16.52).结论宁波市手足口病疫情处于高流行态势,＜5岁散居儿童是主要发病人群,EV71为优势株；EV71毒株为C4a亚群,CoxA16毒株为B1基因亚型,与中国大陆优势株流行趋势一致.
목적 분석2008-2011년저파시수족구병류행특정.방법 종질병감측신식보고관리계통획취저파시2008-2011년수족구병자료,운용묘술류행병학방법진행분석.대분편표본채용RT-PCR확증기인서렬측정,병이용생물학연건분석.결과 2008-2011년저파시공보고수족구병병례37 524례,기중중증196례,사망12례,년균발병솔위145.26/10만,병사솔위0.03％.＜5세인동점보고병례적95.89％,산거인동점64.10％；각지구발병균처우교고수평,기중저해、상산현위발병솔최고적지구,발병고봉재4-7월,남성다우녀성.실험실학진2394례,장도병독(EV)71형시주요적병독주,진화수분석표명저파시수족구병EV71분리주속우C4a진화분지,기류행화전파존재다개전파련.Cox A16주동시포함Bla화Bib량조진화분지공동류행.건강인동EV71중화항체양성솔위53.48％,GMT위11.23(8.33 ～ 14.98)；Cox A16중화항체양성솔위63.18％,GMT위12.61(6.70 ～ 16.52).결론 저파시수족구병역정처우고류행태세,＜5세산거인동시주요발병인군,EV71위우세주；EV71독주위C4a아군,CoxA16독주위B1기인아형,여중국대륙우세주류행추세일치.
Objective To analyze the epidemiological characteristics of hand foot and mouth disease (HFMD) in Ningbo.Methods A descriptive analysis was conducted through the surveillance data of HFMD in Ningbo,Zhejiang province,from 2008 to 2011.Genes on EV71 and Cox A16were amplified with RT-PCT from the stool samples of HFMD patients.Sequences were analyzed by bioinformatics software.Results 37 524 cases of HFMD were reported from 2008 to 2011,including 196 severe cases and 12 deaths.The reported incidence was 145.26 per 100 000 and the case fatality was 0.03％.Cases in children aged 5 or younger accounted for 95.89％,and the scattered cases accounted for 64.10％.Xiangshan and Ninghai counties had the highest incidence rates in Ningbo.The peak of incidence was from April to July.The number of male patients was obviously higher than females.2394 cases of HFMD were laboratory confirmed and EV71 with the predominant epidemic strain.Data from phylogenetic analysis revealed that EV71 isolated from HFMD patients in Ningbo belonged to C4a evolution branch of C4 sub-genotype,with several transmission chains.Cox A16belonged to B1 evolution branch.53.48％ of the healthy children in Ningbo showed EV71 antibody positive.The geometric mean of the antibody titer (GMT) was 11.23 (8.33-14.98) in healthy children.Cox A16 antibody was detected at 63.18％ of the healthy children in Ningbo.GMT in healthy children was 12.61 (6.70-16.52).Conclusion HFMD was highly endemic in Ningbo,with children under 5 years old were at high-risk.The major etiologic agent was EV71 which belonged to C4a in the C4 sub-genotypes.Cox A16 belonged to the B1 evolution branch,which were in line with the predominant virus circulating in the mainland of China.