| 樊欢,李明阳,石平,曹子轩,许倩,嵇红.江苏省3个城市疱疹性咽峡炎流行病学与病原学特征分析[J].Chinese journal of Epidemiology,2024,45(7):977-982 |
| 江苏省3个城市疱疹性咽峡炎流行病学与病原学特征分析 |
| Epidemiological and etiological characteristics of herpes pharyngitis in 3 prefectures in Jiangsu Province |
| Received:December 25, 2023 |
| DOI：10.3760/cma.j.cn112338-20231225-00374 |
| KeyWord: 疱疹性咽峡炎 流行病学特征 肠道病毒 基因型 |
| English Key Word: Herpes pharyngitis Epidemiological characteristic Enterovirus Genotype |
| FundProject:国家自然科学基金青年科学基金（81402732）;江苏省卫生和计划生育委员会青年人才项目（QNRC2016552） |
| Author Name | Affiliation | E-mail | | Fan Huan | Institute of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Key Laboratory of Enteric Pathogenic Microorganisms, National Health Commission, Nanjing 210009, China | | | Li Mingyang | Division of Acute Infectious Disease Prevention and Control, Nantong Prefectural Center for Disease Control and Prevention, Nantong 226001, China | | | Shi Ping | Division of Acute Infectious Disease Prevention and Control, Wuxi Prefectural Center for Disease Control and Prevention, Wuxi 214023, China | | | Cao Zixuan | Division of Acute Infectious Disease Prevention and Control, Yancheng Prefectural Center for Disease Control and Prevention, Yancheng 224001, China | | | Xu Qian | Department of Acute Infectious Disease Prevention and Control, Suzhou Prefectural Center for Disease Control and Prevention, Suzhou 215026, China | | | Ji Hong | Institute of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Key Laboratory of Enteric Pathogenic Microorganisms, National Health Commission, Nanjing 210009, China | jihong1982@sina.cn |
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| Abstract: |
| 目的 分析江苏省3个城市疱疹性咽峡炎（HA）流行病学与病原学特征，为江苏省HA的精准防控提供参考依据。方法 选择无锡市、苏州市和盐城市的3家监测哨点医院，2018年5月至2022年12月定期从医院住院管理系统分年龄段收集HA的就诊和住院病例的相关信息。采用RT-PCR方法进行肠道病毒核酸检测，并对主要流行株的衣壳蛋白VP1编码基因序列进行测序分析、基因亚型的鉴别和系统进化分析。结果 无锡市、苏州市和盐城市的HA就诊病例数为57 709例，是同期报告的手足口病例数的1.76倍（57 709/32 831）；HA住院占比为1.35%（781/57 709），住院占比逐年呈上升趋势（χ2=62.79，P<0.001）。HA流行高峰为5-7月。发病年龄主要为12~59月龄组儿童（67.07%，38 708/57 709），以36~59月龄组居多（34.40%，19 852/57 709）。HA阳性率为33.82%（644/1 904）；以肠道病毒A组为主（54.04%，348/644）；其中柯萨奇病毒（CV）A6占比最高（52.59%，183/348），CVA16和CVA4分别占24.71%（86/348）和15.23%（53/348）。10株CVA4 HA流行株均属于C2基因亚型，6株CVA6 HA流行株均属于D3a基因亚型；并与我国部分地区（福建省、广州市、江西省、云南省、天津市等）毒株的遗传距离和亲缘关系较为接近。结论 HA疾病负担较重，12~59月龄组是HA发病的重点人群，流行高峰为5-7月。HA病原多样化，以肠道病毒A组为主。HA流行株具有较低的型内分化，未发现新的进化分支。建议将HA纳入手足口病监测工作或法定传染病。 |
| English Abstract: |
| Objective To analyze the epidemiological and etiological characteristics of herpes pharyngitis (HA) in three prefectures of Jiangsu Province, and provide evidence for the prevention and control of HA in Jiangsu. Methods Three surveillance sentinel hospitals in Wuxi, Suzhou and Yancheng were selected from May 2018 to December 2022, and information related to HA visits and hospitalized cases was regularly collected from the hospital inpatient management system by age groups. Enterovirus nucleic acid detection was performed by RT-PCR, and sequencing analysis, identification of genotype subtypes, and phylogenetic analysis were performed on the sequences of the gene encoding the coat protein VP1 of the main prevalent strains. Results A total of 57 709 HA cases were recorded in the sentinel hospitals in in Wuxi, Suzhou and Yancheng, which was 1.76 times higher than the reported cases of hand, foot and mouth disease during the same period (57 709/32 831).The percentage of HA hospitalizations was 1.35% (781/57 709), and the percentage of hospitalizations showed an increasing trend from year to year (χ2=62.79, P<0.001).The incidence peak of HA was during May-July. The cases were mainly children aged 12-59 months (67.07%, 38 708/57 709), with the highest case number in age group 36-59 months (34.40%, 19 852/57 709). The HA positivity rate was 33.82% (644/1 904); enterovirus A was predominant (54.04%, 348/644); of these, Coxsackievirus (CV) A6 accounted for the highest percentage (52.59%, 183/348), while CVA16 and CVA4 accounted for 24.71% (86/348) and 15.23% (53/348), respectively. All 10 CVA4 HA endemic strains belonged to the C2 gene subtype, and all 6 CVA6 HA endemic strains belonged to the D3a gene subtype; and were genetically closer to and related to the strains in some areas of China (Fujian Province, Guangzhou City, Jiangxi Province, Yunnan Province, Tianjin City, etc.). Conclusions The disease burden of HA was heavy in 3 areas in Jiangsu, children in age group 12-59-month were mainly affected, and the annual incidence peak of HA was during May-July. The pathogens causing HA varied, but predominated by enterovirus A and had low intra-typical differentiation, and no new evolutionary branches were found, suggesting that it is necessary to include HA in foot and mouth disease surveillance or regarded as a notifiable communicable disease. |
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