2010--2012年东莞市手足口病病原学监测结果分析

目的分析东莞市2010--2012年手足口病病原学特征和流行病学特征，为适时调整手足口病的防治方案提供参考资料。方法收集2010--2012年东莞市手足口病病原学监测标本、重症病例和聚集性疫情作为研究对象，用RealtimeRT—PCR法对患者标本进行肠道病毒通用型、肠道病毒7l型（EV71）和柯萨奇病毒A组16型（CoxA16）的特异性核酸检测。结果共检测手足口病病例各类标本2282份，肠道病毒通用型核酸阳性2026份，检出率88．78％（2026／2282），其中，EV71、CoxA16、EV71和CoxA16混合感染、未分型类（即其他肠道病毒）的阳性病例分别占肠道病毒感染阳性的46．25％（937／2026）、18．36％（372／2026）、0．10％（2／2026）和35．29％（715／2026）。2010年东莞市HFMD病原以EV71为主，构成比为60．63％（516／851），而2011和2012年HFMD病原主体是其他肠道病毒，其构成比为39．29％（211／537）和44．67％（285／638）。东莞市HFMD全年均有发病，高峰期主要为每年的4-6月（41．24％，941／2282）；男性发病例数（1483例）多于女性（799例）；病例以5岁以下儿童为主（92．73％，2116／2282）。分析2026例肠道病毒阳性病例，其中轻、重症病例分别占所有病例的70．53％（1429／2026）、28．97％（587／2026），死亡病例10例。重症病例以EV71为主．其构成比为81．43％（478／587），死亡病例均为EV71核酸阳性。结论2010年东莞市手足口病病原体以EV71为主，2011年和2012年其他肠道病毒已经成为东莞市手足口病最主要的病原体。EV71仍然是引起手足口重症和死亡病例的优势流行型别。

Surveillance of hand-foot-mouth disease in Dongguan City, 2010 - 2012

Objective To analyze the pathogenic characteristics and epidemiological data of hand- foot-mouth disease （HFMD） cases in Dongguan City from 2010 to 2012, and provide the reference for timely adjustment of the prevention and control scenario. Methods Specimens of HFMD cases including surveillance cases, severe cases and outbreaks in Dongguan City from 2010 to 2012 were collected for detec- ting the specific nuclear acids of general enterovirus, Coxsackievirus A16 （Cox A16）, and Enterovirus 71 （ EV 71 ） by Real-time RT-PCR. Results A total of 2 282 samples of HFMD cases were detected and 2 026 were general enterovirus nuclear acids positive, with a detection rate of 88.78% （2 026/2 282）. Of the 2 026 cases, 937 （46.25%） were infected with EV 71, 372 （18.36%） were Cox A16, 2 （0. 10% ） were mixed infection of EV 71 and Cox A16, and 715 （35.29%） were other enterovirus, respectively. EV 71 was the major pathogen （60. 63% , 516/851） in 2010. While the other enteroviruses were predomi- nant in 2011 （39.29% , 211/537） and 2012 （44.67% , 285/638）, respectively. HFMD occurred all the year round and the peak of HFMD cases were mainly from April to June each year （41.24% ,941/2 282）. Most of the cases were children under 5 years （92. 73% , 2 116/2 282）. Of all the cases, 1 483 were males and 799 were females. Of the 2 026 cases, 1 429 （70. 53% ） were mild and 587 （28.97%） weresevere. EV 71 was the predominant pathogen in severe cases （81.43% , 478/587） , as well as in all death cases（ 10 cases）. Conclusion EV 71 was the predominant pathogen of HFMD in Dongguan City in 2010. However, other enteroviruses became predominant in 2011 and 2012. EV 71 is still the predominant type for severe and fatal HFMD cases.