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不同类型肠道病毒感染所致手足口病流行病学调查

Epidemiological characteristics of hand-foot-mouth disease caused by different types of enterovirus
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摘要 目的调查不同肠道病毒感染所致手足口病(hand foot mouth disease,HFMD)患儿家庭密切接触者肠道病毒感染情况及其传播因素分析。方法选取杭州市儿童医院2016年4~7月住院的HFMD患儿。对患儿及密切接触的家庭成员进行临床状况评估及病毒学检测,并进行问卷调查。同期收集杭州某医院体检中心体检的正常成人粪便68份及杭州某幼儿园正常幼托儿童粪便400份;采用实时荧光聚合酶链反应(RT-PCR)法进行病毒检测及分型。结果 150例肠道病毒检测阳性的HFMD患儿年龄以1~3岁为主(57.33%)。人肠道病毒71型(HEV71)75例,阳性率50.00%,柯萨奇病毒A16型(CA16)16例,阳性率为10.67%,其他肠道病毒59例,阳性率为39.33%。与75例EV71阳性患儿有密切接触的家庭成员108例,31份粪便样本中EV71病毒核酸阳性,占28.70%(31/108);与16例CA16阳性患儿有密切接触的家庭成员28例,9份粪便样本CA16病毒核酸阳性,占32.14%(9/28);与59例肠道病毒通用型阳性患儿有密切接触的家庭成员81例,21份粪便样本肠道病毒通用型病毒核酸阳性,占25.93%(21/81);同期检测的正常成人粪便肠道病毒核酸均阴性;检测的正常幼托儿童粪便1份肠道病毒阳性。而家庭成员中有幼托儿童且该幼托儿童近期有患病,是引起HFMD家庭聚集性传播的危险因素。结论不同类型肠道病毒感染所致HFMD家庭传播率差异无统计学意义;家庭因素只是HFMD传播中的一种因素。 Objective To understand the epidemiological characteristics of hand-foot-mouth disease(HFMD)caused by different types of enterovirus,and to observe the virus transmission among family members.Methods Children with HFMD hospitalized from April 2016 to July 2016 in Hangzhou children′s Hospital were enrolled into the study.Clinical evaluation,virological assay and questionnaire-based interviews were performed among patients and their close family contacts.Meanwhile,fecal samples were also collected from healthy adults(68 samples)and from healthy kids(400 samples).Real-time polymerase chain reaction(RT-PCR)was used for the virus identification.Data were analyzed by chi square test and logistic regression.Results A total of 150 patients had laboratory-confirmed enterovirus infection.The male to female ratio was 1.5∶1 and 57.33%of patients were 1-3 years old kids.50.00%,10.67%and 39.33%were positive for human enterovirus 71(HEV71),Coxsackie virus group-A type-16(CVA16)and other enteroviruses.Out of total 108,28 and 21 fecal samples collected from family members closely contacted with 75 cases of EV71,16 cases of CVA16 and 59 cases of other enteroviruses positive children,31(28.70%),9(32.14%)and 21(25.93%)were PCR positive for EV71 virus,CA16 virus and other enteroviruses.While,68 fecal samples from healthy adults were all enterovirus negative,and only 1 enterovirus positive sample was found in 400 fecal samples from healthy children.Having a day care child who had HFMD in the family was a risk factor for HFMD intrafamilial transmission.Conclusions There was no significant difference in the family transmission of HFMD caused by different types of enterovirus.Family factor is one of the major factors affecting the transmission of HFMD.
作者 林先耀 赵仕勇 祁正红 陈海哨 吴亦栋 韦翊 LIN Xian-yao;ZHAO Shi-yong;QI Zheng-hong;CHEN Hai-xiao;WU Yi-dong;WEI Yi(Hangzhou Children′s Hospital,Hangzhou,Zhejiang 310014,China)
出处 《中国预防医学杂志》 CAS CSCD 2019年第7期584-587,共4页 Chinese Preventive Medicine
基金 浙江省医药卫生科技计划项目(2018KY143) 杭州市卫生计生科技计划项目(2015Z09).
关键词 手足口病 隐性感染 家庭传播 肠道病毒 流行病学 Hand-foot-mouth disease Latent infection Family transmission Enterovirus
作者简介 林先耀,硕士研究生,主治医师,主要从事儿童感染相关性疾病研究;通信作者:韦翊,E-mail:jhwy3993@sina.com
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