海南西部地区手足口病流行病学及病原学特征分析

目的了解2012—2015年海南西部地区手足口病(hand-foot-mouth disease,HFMD)流行病学及病原学特征,为防控工作提供依据。方法收集2012年1月—2015年12月海南西部地区10 258例HFMD患儿的资料,分析其流行病学特征。对粪便或咽拭子标本采用实时荧光定量PCR扩增基因序列进行肠道病毒71型(enterovirus 71,EV71)、柯萨奇病毒A组(Coxasckie virus A,CA)16型和其他肠道病毒核酸检测。结果 2012—2015年海南西部地区累计报告HFMD患儿10 258例,年发病率为121.34/10万,病死率为0.19%。HFMD患儿发病年龄主要集中在5岁儿童,其中1~3岁组发病率最高,占69.31%。HFMD发病有明显的季节性,发病高峰出现在5—8月,呈单峰分布。实验室诊断率为60.20%(6175/10 258),其中EV71阳性3907例(63.27%),CA16阳性875例(14.17%),其他肠道病毒阳性1393例(22.56%)。EV71和CA16感染构成比随季节变换而发生变化,EV71构成比在5月份高达74.28%(719/968),CA16构成比在8月份高达19.44%(146/751)。重症患儿和死亡患儿均以EV71感染构成比最高,分别占80.00%(20/25),81.82%(9/11)。结论海南西部地区HFMD疫情处于高流行态势,5岁儿童是主要发病人群,EV71和CA16为主要病原,应采取相应措施,更好防控HFMD的发生和流行。

Epidemiological and etiological characteristics analysis of hand-foot-mouth disease in western Hainan

Objective To understand the epidemiological and etiological characteristics of hand-foot-mouth disease (HFMD) in western Hainan from 2012 to 2015, and provide evidence for prevention and control. Methods Data of 10 258 children with HFMD were collected from January 2012 to December 2015 in western Hainan, and their epidemiological characteristics were analyzed. The quantitative real-time PCR was used to amplify gene sequences and detect the enterovirus 71 (EV71), Coxasckie virus A 16 (CAl6) and other intestinal viral nucleic acids in stool or throat swab specimens. Results The cumulative report of 10 258 children with HFMD from 2012 to 2015 in western Hainan was found, with an annual incidence of 121.34/105and a mortality rate of 0.19%. The majority of children with HFMD aged less than 5 years, among which the age group of 1 to 3 years had the highest incidence, accounting for 69.31%. The episodes of HFMD had obvious seasonal characteristics. The onset of disease peaked during May to August, showing a single peak distribution. Laboratory diagnosis rate was 60.20% (6175/10 258) in 10 258 children with HFMD, of which EV71 positive in 3907 cases (63.27%), CA16 positive in 875 cases (14.17%), and other intestinal virus positive in 1393 cases (22.56%). The composition ratio of EV71 and CA16 infection varied from different seasons, and the composition ratio of EV71 was up to 74.28% (719/968) in May, and the composition of CAl6 was 19.44% (146/751) in August. The ratio of EV71 infection was the highest in both severe and dead children, 80% (20/25) and 81.82% (9/11), respectively. Conclusions The HFMD in western Hainan shows a high epidemic situation, children aging less than 5 years are the most prevalent, EV71 and CAl6 are the main pathogens. Corresponding measures should be taken to prevent and control the onset and prevalence of HFMD.