2010-2017年上海市浦东新区发热伴出疹性疾病病原学分析

费怡; 邓鹏飞; 杨天; 杨来宝; 王卫平; 王琦璋; 周翠萍; 郝莉鹏

doi:10.16462/j.cnki.zhjbkz.2019.05.012

2010-2017年上海市浦东新区发热伴出疹性疾病病原学分析

doi: 10.16462/j.cnki.zhjbkz.2019.05.012

200136 上海市浦东新区疾病预防控制中心复旦大学浦东预防医学研究院

费怡、邓鹏飞为共同第一作者

基金项目:

国家科技重大专项 2018ZX10713-001-008

详细信息

通讯作者:
郝莉鹏, E-mail: hlpmai@126.com

中图分类号: R183.7
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出版历程
- 收稿日期: 2018-10-25
- 修回日期: 2019-01-29
- 刊出日期: 2019-05-10

Study on the etiology of rash and fever illness in Pudong New Area of Shanghai from 2010 to 2017

Center for Diseases Control and Prevention Fudan University Pudong Institute of Preventive Medicine, Shanghai Pudong, Shanghai 200136, China FEI Yi and DENG Peng-fei are the first authors who contributed equally to the article

FEI Yi and DENG Peng-fei are the first authors who contributed equally to the article.

Funds:

National Science and Technology Key Project 2018ZX10713-001-008

More Information

Corresponding author: HAO Li-peng, E-mail: hlpmai@126.com

摘要

摘要: 目的分析2010年1月~2017年12月浦东新区发热伴出疹性疾病(rash and fever illness，RFIs)的病原谱构成及流行特征，为RFIs防控提供科学依据。方法采用酶联免疫吸附法和实时荧光定量聚合酶链反应对2 381例临床标本进行肠道、麻疹、风疹等病毒的病原学检测，并进行统计分析。结果 2 381例样本中RFIs检测阳性1 633例(68.59%)。病原谱构成前4位病毒分别是肠道(52.54%)、麻疹(28.54%)、风疹(13.04%)、水痘-带状疱疹(3.37%)。男性风疹病原体检出率高于女性，差异有统计学意义(P=0.026)。年龄组分布中，肠道病毒集中在3~6岁年龄组，水痘-带状疱疹病毒集中在6~18岁年龄段，麻疹病毒、风疹病毒、登革热病毒、小DNA病毒集中在18岁以上年龄段，不同年龄组的病原体检出率差异均有统计学意义(均有P < 0.05)。RFIs发病集中在春季(41.52%)，冬季最少(15.00%)，其中肠道、麻疹、风疹、登革热病毒在不同季节的病原体检出率差异有统计学意义(P < 0.05)。结论肠道和麻疹病毒是本地RFIs感染的主要病原体，应长期监测RFIs病原体的活动水平。
- 发热伴出疹性疾病 /
- 流行病学 /
- 聚合酶链反应
Abstract: Objective To investigate the pathogens spectrum and epidemiological characteristics of rash and fever illness (RFIs) from January 2010 to December 2017 in Pudong New Area, in order to provide scientific evidence for the prevention and control ofRFIs. Methods Enzyme-linked immunosorbent assay and real-time fluorescence quantitative polymerase chain reaction were used to detect the pathogens of enterovirus, measles virus, rubella virus and others from 2 831 clinical samples, and statistical analysis was performed. Results Pathogens were found in 1 633 samples in total, accounting for 68.59%. The top 4 viruses in the pathogen spectrum were enterovirus (52.54%), measles virus (28.54%), rubella virus (13.04%), and varicella-zoster virus (3.37%). There was significnat difference in the detection rate of rubella pathogens among patients of different genders(P=0.026). In the pathogen spectrum of infections of different age groups, the detection rate of enteroviruses at the age of 3-6 years was higher than that of other age groups. The detection rate of varicella-zoster virus at the age of 6-18 years old was higher than that of other age groups. The detection rate of virus including measles virus, rubella virus, dengue virus and small DNA virus in age of 18 and older was higher than that of other age groups. There was significant difference in the detection rate of pathogens in different age groups (all P < 0.05).The incidence of RFIs was the highest in spring (41.52%) and the lowest in winter (15.00%). There was a statistical difference in the detection rate of enterovirus, measles, rubella and dengue virus in different seasons (P < 0.05). Conclusions Enteroviruses and measles viruses are the main pathogens leading to RFIs in Pudong New Area, and the activity level of RFIs pathogens should be monitored for a long time.
- Rash and fever illness /
- Epidemiology /
- Polymerase chain reaction

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表 1 不同性别RFIs病原体检测情况分析

Table 1. Analysis of pathogen detection in RFIs of different sexes

病原体检测		性别[n(%)]		合计[n(%)]	χ²值	P值
病原体检测		男	女	合计[n(%)]	χ²值	P值
肠道病毒	阴性	331(59.64)	224(40.36)	555(39.28)	0.433	0.510
	阳性	528(61.54)	330(38.46)	858(60.72)
麻疹病毒	阴性	573(58.29)	410(41.71)	983(67.84)	0.002	0.961
	阳性	273(58.58)	193(41.42)	466(32.16)
风疹病毒	阴性	697(56.39)	539(43.61)	1 236(85.30)	13.200	＜0.001
	阳性	149(69.95)	64(30.05)	213(14.70)
水痘病毒	阴性	1 071(59.63)	725(40.37)	1 796(97.03)	0.035	0.853
	阳性	34(61.82)	21(38.18)	55(2.97)
登革热病毒	阴性	1 090(59.99)	727(40.01)	1 817(98.16)	2.866	0.091
	阳性	15(44.12)	19(55.88)	34(1.84)
人类小DNA病毒	阴性	1 098(59.61)	744(40.39)	1 842(99.62)	-	0.708^a
	阳性	5(71.43)	2(28.57)	7(0.38)
总检出情况	阴性	423(56.55)	325(43.45)	748(31.42)	4.992	0.026
	阳性	1 004(61.48)	629(38.52)	1 633(68.58)
注：^a采用fisher精确概率法计算。

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表 2 不同年龄组RFIs阳性病例病原体检出情况分析[n(%)]

Table 2. Analysis of pathogen detection in RFIs positive cases of different age groups[n(%)]

年龄段	＜12月龄(n=192)	1~(n=465)	3~(n=668)	6~(n=241)	≥18岁(n=815)	合计(n=2381)	χ²值	P值
肠道	41(4.78)	322(37.53)	421(49.07)	74(8.62)	0(0.00)	858(52.54)	221.843	＜0.001
麻疹	81(17.38)	15(3.22)	9(1.93)	7(1.50)	354(75.97)	466(28.54)	270.494	＜0.001
风疹	3(1.41)	2(0.94)	2(0.94)	13(6.10)	193(90.61)	213(13.04)	151.267	＜0.001
水痘	3(5.45)	3(5.45)	13(23.64)	21(38.18)	15(27.27)	55(3.37)	-	＜0.001^a
登革热	1(2.94)	1(2.94)	1(2.94)	4(11.76)	27(79.41)	34(2.08)	-	＜0.001^a
小DNA病毒	0(0.00)	0(0.00)	1(14.29)	1(14.29)	5(71.43)	7(0.43)	-	0.033^a
阳性合计	129(7.90)	343(21.00)	447(27.37)	120(7.35)	594(36.37)	1 633(100.00)	53.315	＜0.001
注：^a采用fisher精确概率法计算。

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表 3 不同性别的季节发热伴出疹阳性病例病原体检出情况分析[n(%)]

Table 3. Analysis of pathogen detection in RFIs positive cases of different seasons in different sexes[n(%)]

项目	春季	夏季	秋季	冬季	χ²值	P值
肠道	233(27.16)	207(24.13)	279(32.52)	139(16.20)	15.647	0.001
麻疹	262(56.22)	115(24.68)	27(5.79)	62(13.30)	49.788	＜0.001
风疹	151(70.89)	23(10.80)	13(6.10)	26(12.21)	53.369	＜0.001
水痘	12(21.82)	19(34.55)	13(23.64)	11(20.00)	7.083	0.069
登革热	18(52.94)	10(29.41)	1(2.94)	5(14.71)	11.922	0.007
小DNA病毒	2(28.57)	2(28.57)	1(14.29)	2(28.57)	-	0.718^a
合计	678(41.52)	376(23.03)	334(20.45)	245(15.00)	21.261	＜0.001
男
肠道	148(28.03)	122(23.11)	178(33.71)	80(15.15)	9.530	0.023
麻疹	158(57.88)	57(20.88)	15(5.49)	43(15.75)	28.290	＜0.001
风疹	109(73.15)	14(9.40)	9(6.04)	17(11.41)	64.821	＜0.001
水痘	8(23.53)	8(23.53)	12(35.29)	6(17.65)	1.904	0.593
登革热	8(53.33)	5(33.33)	1(6.67)	1(6.67)	-	0.105^a
小DNA病毒	2(40.00)	1(20.00)	1(20.00)	1(20.00)	-	0.975^a
合计	433(43.13)	207(20.62)	216(21.51)	148(14.74)	18.950	＜0.001
女
肠道	85(25.76)	85(25.76)	101(30.61)	59(17.88)	6.663	0.083
麻疹	104(53.89)	58(30.05)	12(6.22)	19(9.84)	27.075	＜0.001
风疹	42(65.63)	9(14.06)	4(6.25)	9(14.06)	12.093	0.007
水痘	4(19.05)	11(52.38)	1(4.76)	5(23.81)	-	0.003^a
登革热	10(52.63)	5(26.32)	0(0.00)	4(21.05)	-	0.023^a
小DNA病毒	0(0.00)	1(50.00)	0(0.00)	1(50.00)	-	0.227^a
合计	245(38.95)	169(26.87)	118(18.76)	97(15.42)	12.434	0.006
注：^a采用fisher精确概率法计算。

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参考文献(16)

[1]	Matsushima Y, Shimizu T, DoiI, et al. A method for detecting rash and fever illness-associated viruses using multiplex reverse transcription polymerase chain reaction[J]. Microbiol Immunol, 2017, 61(8): 337-344. DOI: 10.1111/1348-0421.12502.
[2]	任晓卫, 王新华, 王玉. 西北地区2009-2011年发热伴出疹症候群流行病学特征分析[J]. 中华疾病控制杂志, 2012, 16(10): 913-914. http://zhjbkz.ahmu.edu.cn/article/id/JBKZ201210025 Ren XW, Wang XH, Wang Y. A study of epidemiological characteristics of rash and fever illness in Northwest China, 2009-2011[J]. Chin J Dis Control Prev. 2012, 16(10): 913-914. http://zhjbkz.ahmu.edu.cn/article/id/JBKZ201210025
[3]	琚雄飞, 许岸高, 方巧云, 等. 2010-2012年广东省发热伴出疹症候群的病原学研究[J]. 中华疾病控制杂志, 2013, 17(8): 670-673. http://zhjbkz.ahmu.edu.cn/article/id/JBKZ201308008 Ju XF, Xu AG, Fang QY, et al. Etiology study on rash and fever illness in Guangdong Province, 2010-2012[J]. Chin J Dis Control Prev. 2013, 17(8): 670-673. http://zhjbkz.ahmu.edu.cn/article/id/JBKZ201308008
[4]	苏琪茹, 马超, 郝利新, 等. 中国2011-2013年麻疹监测信息报告管理系统监测病例分类情况分析[J]. 中国疫苗和免疫, 2014, 20(3): 200-204, 215. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM201403002.htm Su QR, Ma C, Hao LX, et al. The classification of measles cases reported from measles surveillance information reporting management system in China, 2011-2013[J]. Chinese Journal of Vaccines and Immunization. 2014, 20(3): 200-204, 215. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM201403002.htm
[5]	Huff AG, Allen T, Whiting K, et al. Biosurveillance: a systematic review of global infectious disease surveillance systems from 1900 to 2016[J]. Rev Sci Tech, 2017, 36(2): 513-524. DOI: 10.20506/rst.36.2.2670.
[6]	Simonsen L, Gog JR, Olson D, et al. Infectious disease surveillance in the big data era: towards faster and locally relevant systems[J]. J Infect Dis, 2016, 214(s): S380-S385. DOI: 10.1093/infdis/jiw376.
[7]	Buckee CO, Cardenas M, Corpuz J, et al. Productive disruption: opportunities and challenges for innovation in infectiousdisease surveillance[J]. BMJ Glob Health, 2018, 3(1): e538. DOI: 10.1136/bmjgh-2017-000538.
[8]	邱琪, 柴志凯, 郜慧, 等. 2009~2015年中国山西省发热伴出疹症候群病毒性病原谱流行特征[J]. 病毒学报, 2017, 33(2): 169-175. DOI: 10.13242/j.cnki.bingduxuebao.003117. Qiu Q, Chai ZK, Gao H, et al. Epidemiological characteristics of viral pathogen spectrum of fever with rash syndrome in Shanxi Province, China, from 2009 to 2015[J]. Chinese Journal of Virology, 2017, 33(2): 169-175. DOI: 10.13242/j.cnki.bingduxuebao.003117.
[9]	刘燕, 方巧云, 曾健君, 等. 惠州市2011-2016年发热伴出疹性疾病病原学分析[J]. 中国热带医学, 2017, 17(11): 1086-1088. DOI: 10.13604/j.cnki.46-1064/r.2017.11.06. Liu Y, Fang QY, Zeng JJ, et al. Etiology study on rash and fever illness in Huizhou, 2011-2016[J]. China Tropical Medicine, 2017, 17(11): 1086-1088. DOI: 10.13604/j.cnki.46-1064/r.2017.11.06.
[10]	党露希, 王灿, 鲍武波, 等. 武汉市洪山区EV71疫苗防控效果初探[J]. 现代预防医学, 2018, 45(3): 446-448. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201803017.htm Dang LX, Wang C, Bao WB, et al. Prevention and control effect of enterovirus 71 vaccine inoculation on HFMD in Hongshan District, Wuhan[J]. Modern Preventive Medicine, 2018, 45(3): 446-448. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201803017.htm
[11]	宋秦伟, 黄辉, 邓洁, 等. 2013至2014年北京手足口病流行季相关肠道病毒型别变化和分析[J]. 中华儿科杂志, 2015, 14(8): 610-615. DOI: 10.3760/cma.j.issn.0578-1310.2015.08.014. Song QW, Huang H, Deng J, et al. Analysis on the change of genotype of enteroviruses associated hand, foot and mouth disease in Beijing during 2013 to 2014[J]. Chinese Journal of Pediatrics. 2015, 14(8): 610-615. DOI: 10.3760/cma.j.issn.0578-1310.2015.08.014.
[12]	李欣影, 文锐玲, 林桂鸿, 等. 广东省惠州市2011-2015年发热伴出疹症候群病原谱和流行病学特征分析[J]. 岭南急诊医学杂志, 2018, 20(3): 260-264. doi: 10.3969/j.issn.1671-301X.2018.03.020 Li XY, Wen RL, Lin GH, et al. Pathogens and epidemiological characteristic studies on rash and fever illness in Huizhou of Guangdong province from 2011 to 2015[J]. Lingnan Journal of Emergency Medicine, 2018, 20(3): 260-264. doi: 10.3969/j.issn.1671-301X.2018.03.020
[13]	耿倩, 陈蓉, 张涛, 等. 2006-2011年上海市麻疹流行病学特征分析[J]. 中华疾病控制杂志, 2013, 17(11): 955-958. http://zhjbkz.ahmu.edu.cn/article/id/JBKZ201311011 Geng Q, Chen R, Zhang T, et al. Epidemiologic characteristics of measles in Shanghai, 2006-2011[J]. Chin J Dis Control Prev, 2013, 17(11): 955-958. http://zhjbkz.ahmu.edu.cn/article/id/JBKZ201311011
[14]	沈奕峰, 任亚萍, 谢彦昕, 等. 2012-2016年上海市浦东新区水痘暴发疫情流行病学分析[J]. 公共卫生与预防医学, 2018, 24(2): 90-93. https://www.cnki.com.cn/Article/CJFDTOTAL-FBYF201802025.htm Shen YF, Ren YP, Xie YX, et al. Epidemiological analysis of varicella outbreak in Pudong New Area of Shanghai (2012-2016)[J]. Journal of Public Health and Preventive Medicine, 2018, 24(2): 90-93. https://www.cnki.com.cn/Article/CJFDTOTAL-FBYF201802025.htm
[15]	孟凤霞, 王义冠, 冯磊, 等. 我国登革热疫情防控与媒介伊蚊的综合治理[J]. 中国媒介生物学及控制杂志, 2015, 26(1): 4-10. DOI: 10.1093/infdis/jiw400. Meng FX, Wang YG, Feng L, et al. Review on dengue prevention and control and integrated mosquito management in China[J]. Chinese Journal of Vector Biology and Control, 2015, 26(1): 4-10. DOI: 10.1093/infdis/jiw400.
[16]	Bansal S, Chowell G, Simonsen L, et al. Big data for infectious disease surveillance and modeling[J]. J Infect Dis, 2016, 214(s): S375-S379. DOI: 10.1093/infdis/jiw400.