2008年广东省儿童手足口病病原学监测

目的监测手足口病的病原体,为预防和控制肠道病毒感染提供依据。方法采集手足口病患儿的粪便、肛拭子、咽拭子、疱疹液进行RT-PCR定性,肠道病毒通用引物阳性的标本进行病毒分离;分离株用EV71和CA16的VP1基因的特异性引物进行RT-PCR鉴定。结果共收集患儿标本443份,肠道病毒通用引物阳性259份;做病毒分离256份,阳性150份,其中粪便158份,病毒分离阳性112份,阳性率为70.89%;肛拭子21份,病毒分离阳性10份,阳性率为47.62%;咽拭子65份,病毒分离阳性26份,阳性率为40.00%;疱疹液10份,病毒分离阳性2份,阳性率为20.00%。结论粪便、肛拭子、咽拭子、疱疹液的分离率有显著差异,粪便分离率最高;EV71和CA16是引起小儿手足口病的主要病原体,死亡病例全部是由EV71病毒引起。

Surveillance on etiological agent of hand, foot and mouth disease (HFMD) of children in Guangdong Province in 2008

Objective To investigate the major etiological agent of hand, foot and mouth disease （HFMD） in children, in order to provide a clue to preventing and controlling the enterovirus infection. Methods 443 specimens of the stool, anus swabs, throat swabs and vesicle fluid were collected from HFMD patients and tested by RT-PCR. The virus was isolated from the positive specimen of enterovirus universal primer. The isolating virus stains were identified by RT-PCR assay with two specific primer pairs for VP1 genes of EV71 and CA16 respectively. Results There were 259 positive specimens of enterovirus universal primer confirmed by virus isolation. 150 of specimens showed pathological changes. 112 specimens showed pathological changes in the 158 stool specimen （70.89 % ）, 10 specimens showed pathological changes in the 21 anus swabs specimen （47.62%）, 26 specimen showed pathological changes in the 65 throat swabs specimens （40.00 % ）, and 2 specimens showed pathological changes in the 10 vesicle fluid specimens （20.00%）. Conclusions The isolating rate of the virus has obvious difference in the stool, anus swabs, throat swabs and vesicle fluid, the isolating rate being highest in the stool. EV71 and CA16 are major pathogens of HFMD, with the death totally caused by EV71 virus.