湖北省十堰市59例柯萨奇病毒A组6型手足口病流行病学特征与临床特点分析

目的 探讨柯萨奇病毒A组6型（coxsackievirus A6,Cox A6）手足口病的流行病学特征与临床特点,为该病的诊治与防控提供参考。方法 2012年10月至2013年9月,收集十堰市570例手足口病临床诊断病例标本,以实时荧光定量聚合酶链反应（real time RT-PCR）法进行手足口病病毒核酸检测并分型,对判定为Cox A6的手足口病确诊病例,采用描述流行病学方法进行流行病学特征与临床特点分析。结果 Cox A6在手足口病确诊病例的病原构成中居第3位（占13.41%,59/440）;5岁以下儿童占100.00%,3岁以下占86.44%,散居、幼托儿童构成比为83.05%和16.95%,全市各县（市、区）全年均有发病,高峰期出现在10-11月,有1起聚集性疫情发生;所有病例在手、足、口或臀部出现皮疹,34.53%的病例出现发热,87.72%的病例出现口腔炎,26.32%的病例出现呼吸系统症状,3例白细胞计数偏高。结论 Cox A6肠道病毒可引起典型的手足口病及聚集性疫情,是手足口病的重要病原体之一,应加强监测与研究。

Epidemiological and clinical characteristics of 59 hand foot and mouth disease cases caused by Cox A6 in Shiyan,Hubei

Objective To understand the epidemiological and clinical characteristics of hand foot and mouth disease （HFMD） caused by Cox A6, and provide reference for the diagnosis, treatment, prevention and control of HFMD. Methods A total of 570 specimens were collected from clinical diagnosed HFMD cases in Shiyan from October 2012 to September 2013, the identification and subtyping of the isolates were conducted with real-time fluorescent quantitative RT-PCR. The epidemiological and clinical characteristics of laboratory confirmed HFMD cases caused by Cox A6 were analyzed. Results In 440 laboratory confirmed HFMD cases, 59 were caused by Cox A6 （13.41%）. All the cases were children aged 〈 5 years and 86. 44% were children aged 〈 3 years. The cases in children outside child care settings and in child care setting accounted for 83.05% and 16. 95% respectively. The cases occurred all the year round with the peak during October-November. One cluster of the cases was observed and all cases had rash on hand, foot, mouth or buttock, among these cases, 34. 53% had fever, 87. 72% had stomatitis, 26. 32% had respiratory symptoms, 3 had high blood cell count. Conclusion Cox A6 is one of important pathogens to cause typical HFMD. It is necessary to strengthen the surveillance and research of Cox A6.