2009—2011年惠州市253例手足口病患儿病原学分析

目的了解2009—2011年惠州市手足口病流行的病原及流行情况。方法采集253份2009—2011年手足口病患儿的标本，采用荧光定量PCR法对患者标本进行核酸检测，对部分结果阳性的样品进行基因序列分型。结果253份样品中，总肠道病毒核酸（PE）检测阳性156份，其中CoxAl6核酸阳性41份，EV71核酸阳性92份；2009年手足口病流行的病原以CoxAl6型为主（69．0％）；2010年和2011年均以EV71型为主（分别为78．1％和67．5％）；30份EV71型病毒的基因测序分型均为EV71-C4a型，2例EV阳性病例标本的病原基因型为ECH03型；肠道病毒阳性率6岁以下儿童占阳性病例的93．5％（146／156），3岁以下幼童占阳性病例的73．0％（114／156）。结论本地区2009年手足口病流行的病原以CoxAl6型为主，2010年和2011年以EV71型为主，3年流行的EV71病原基因型主要为EV71-C4a型，在其它肠道病毒阳性的标本中检出基因型为ECH03的病原；3岁以下的幼童为EV71感染的高危人群，在夏秋季节做好手足口病的防控工作很有必要。

Etiology of hand, foot and mouth disease in 253 children in Huizhou during the period of 2009 to 2011

Objective To investigate the pathogens and prevalence of hand-foot-mouth disease （HFMD） in Huizhou during 2009 to 2011. Methods 253 specimens were collected from the children with HFMD and then were detected using fluorescence quantitative PCR. Some samples with positive results were typed by gene sequencing. Results 156 of 253 samples were PE positive. 41 of the 156 samples were CoxA16 and 92 were EV71. CoxA16 （69%） was the major pathogen in 2009, while EV71 was prevalent in 2010 and 2011 （78.1% and 67.5%, respectively ）. The types of EV71 were EV71-C4a for 30 and ECHO3 for 2. The positive rate of intestinal virus accounted for 93.5% （146/156） in children aged less than 6 and was 73.0% （114/156） in those aged less than 3. Conclusions CoxA16 is the major pathogen for hand-food-mouth disease in 2009 and EV71 is the predominant pathogen in 2010 and 2011. EV71-C4a is the main type of EV71 in the past three years in Huizhou. Children younger than 3 are at high risk for EV7 l infection. Prevention and control of hand-foot-mouth disease in summer and fall is a necessity.