佛山市南海区手足口病轻重症病例病原体的检测分析

目的：了解佛山市南海区手足口病病原学特征，并为建立肠道病毒监测体系提供基础数据。方法：对广州中医药大学附属南海妇产儿童医院2010年6月至12月手足口病哨点检测轻症及重症病例的监测结果进行分析。哨点监测中的轻症病例随机采集5份粪便样本，重症病例在临床诊断的基础上，再取患儿的粪便样本，送佛山市南海区疾病预防控制中心检验室进行检测。结果：每月哨点监测结果显示手足口病轻症病例中以肠道病毒（EV）为主，占65．71％，其中EV71占40．0％；重症病例中EV71病毒检出率较高，占97．44％（含1死亡病例），重症病例集中出现在6—8月，平均年龄3．05±1．13岁，主要集中在3岁以下的儿童，占87．18％，男女病例比例是2．9：1。结论：EV71是2010年下半年佛山市南海区手足口病的优势病原茵，也是引起手足口病死亡和重症病例的主要毒株类型，重症病例好发于0～3岁的男性儿童，集中出现在夏季及初秋。

Pathogen distribution of severe hand-foot-and-mouth disease in Nanhai District of Foshan

Objective ：To analyze the etiological characteristics of hand-foot-and-mouth disease （HFMD） in Nanhai District of Foshan City, and to provide basic data for establishing an intestinal virus monitoring system. Methods：We analyzed the results from sentinel monitoring for mild HFMD cases and from severe HFMD case monitoring among patients who visited our hospital between June and December 2010. From the mild cases which were all identified by sentinel monitoring, 5 stool samples were randomly collected; and from those clinically diagnosed severe cases, stool samples were collected and sent to Laboratory of Foshan Center for Disease Control and Prevention for further detection. Results： Monthly sentinel monitoring showed that EV virus was the predominant pathogen accounting for 65.71% of total mild HFMD cases （ of which EV71 accounted for 40. 0% ）. The EV71 virus was also frequently detected in severe HFMD, accounting for 97.44% the total severe cases （including a death case）. Most of the severe cases appeared between June and August, with a mean of patient age being 3.05 years. Children aged below 3 years old accounted for 87.18% of severe HFMD cases, in which, the male-to-female ratio was 2.9：1. Conclusion：EVT1 was the predominant pathogen causing HFMD and also the major strain leading to death or severe cases of HFMD during the second half of 2010 in Foshan. Severe HFMD is more likely to occurin the boys aged 3 years old during the summer and early autumn.