436例手足口病监测病例病原检测结果分析

目的 对江西省赣州市2012年的手足口病(hand,foot and mouth disease,HFMD)监测病例进行病原检测分析,为制定疾病预防控制措施提供实验室参数.方法 采用Real Time RT-PCR法进行肠道病毒通用核酸(PE)、柯萨奇病毒A组16型(CoxA16)和肠道病毒71型(EV71)特异性核酸检测.并统计HFMD的感染类型及其年龄、性别、地域及发病季节分布情况.结果 疱疹液、肛拭子、咽拭子的HFMD的检出率分别为100.00％、86.31％、73.80％,三者差异有统计学意义(x2=21.48,P＜0.01).咽拭子、肛拭子和疱疹液对EV71和CoxA16基因型总检出率分别为52.67％、58.66％和86.67％,三者差异有统计学意义(x2=8.33,P＜0.05).HFMD监测病例数轻型感染占82.83％、重型感染占15.54％,以EV71感染为主(44.92％).4岁及以下病例占90.49％(390/431);男女比例2.11∶1(296/140);发病地域居于前三位的依次为南康市(14.22％)、赣县(13.76％)和寻乌县(12.84％)；在5月和10月份发病最多(均为14.51％,62/427),其次为9月份(13.58％,58/427).结论 2012年赣州地区儿童HFMD监测病例以EV71感染为主,且多为轻型,南康市、赣县和寻乌县所占比例较高.

Pathogen Test Results for 436 Cases of Hand, Foot and Mouth Disease

Objective To analyze the epidemic situation of hand, foot and mouth disease （HFMD） for 2012 in Ganzhou city of Jiangxi province, and to provide laboratory parameters for disease prevention and control. Methods Real-time RT-PCR was used for the detection of enteroviruses, coxsackievirus A16 （CoxA16） and enterovirus 71 （EV71）. Types of HFMD infection and age, gender, regional and seasonal distribution were recorded. Results The detection rate of HFMD was 100.00%, 86.31% and 73.80% in herpes fluid, anal swab and pharyngeal swab specimens, respectively.. The differences were significant among the three specimens （~=21.48, P〈0.01）. The total detection rate of EV71 and CoxA16 was 52.67%, 58.66% and 86.67% in pharyngeal swab, anal swab and herpes fluid specimens, respectively. The differences were significant among the three specimens （~=8.33, P〈0.05）. Rates of mild and serious infection were 82.83% and 15.54%, respectively. HFMD was mainly caused by EV7 infection （44.92%）. The proportion of HFMD children less than or equal to 4 years of age was 90.49% （390/431）. The male to female ratio of infection was 2.11：1 （296/140）. The top three outbreak areas were Nankang city（14.22%）, Gan county（13.76%） and Xunwu county（12.84%）. The peak inci- dence of HFMD outbreak occurred in May （14.51%, 62/427） and October （14.51%, 62/427）, followed by September （13.58%, 58/427）. Conclusion The 2012 HFMD outbreak was mainly caused by EV71 in Ganzhou city and most cases have mild HFMD. The main distribution areas were Nankang city, Gan county and Xunwu county.