2008-2011年惠州市重症手足口病病原学特征分析

目的分析惠州市2008-2011年手足口病重症病例流行病学特征和病原学特征,为制定手足口病预防控制措施提供科学依据。方法选取惠州市2008-2011年手足口病定点收治医院报告的255例重症病例作为研究对象,采集重症患者发病1周内的咽拭子或肛拭子,用RT-PCR法对患者标本进行总肠道病毒、柯萨奇病毒A组16型(CoxA16)和肠道病毒71型(EV71)的特异性核酸检测。结果 255例重症手足口病病例中,肠道病毒通用型核酸阳性180份,检出率70.59%(180/255),其中EV71、CoxA16、非EV71和CoxA16的其他肠道病毒(other intestinal virus)核酸分别为144、6、30份,占肠道病毒感染阳性的80.0%(144/180)、3.33%(6/180)、16.67%(30/180),非肠道病毒(NEV)75例占29.41%(75/255)。重症病例以5岁以下儿童为主,EV71阳性者中以3岁以下幼童为多,男性多于女性,以散居儿童居多。结论 2008-2011年引起惠州市手足口病重症的病原体以EV71为主,占80%,CoxA16的检出率为3.33%,非EV71和CoxA16其他肠道病毒的检出率为16.67%。EV71是惠州市近四年引起手足口病重症病例的优势流行毒株。RT-PCR可用于手足口病重症病例的快速诊断,对5岁以下儿童手足口病进行病原学检测,及早发现重症病例、及早治疗,是防止手足口病死亡病例的关键。

Analysis of Etiological Characteristics of Severe Hand-foot-mouth Disease in Huizhou from 2008 to 2011

Objective To explore the epidemiologic and etiological characteristics of severe hand-foot-mouth disease(HFMD) cases in Huizhou from 2008 to 2011,so as to provide basis for framing corresponding countermeasures.Methods 255 severe HFMD cases from HFMD designated hospitals in Huizhou from 2008 to 2011 were selected as research objects.Pharynx swab or archos swab specimens were collected within one week after HFMD onset and general enterovirus nucleic acid,specific nucleic acid for Coxsackievirus A16(CoxA16) and Enterovirus 71(EV71) were detected by RT-PCR.Results Enterovirus consensus primer was positive for 180 specimens,indicating a detection rate of 70.59%(180/255).Among the 180 specimens,144,6 and 30 specimens displayed positive EV71,CoxA16 and non-EV71,non-CoxA16 intestinal virus,accounting for 80.0%(144/180),3.33%(6/180) and 16.67%(30/180) respectively.Seventy-five cases showed non-enterovirus infection,accounting for 29.41%(75/255).Main severe HFMD patients were children below 5 years and those with positive EV71 were mainly children below 3 years,more boys than girls and more scattered living children.Conclusions EV71 is the superiority epidemiologic enterovirus strain for severe HFMD cases(accounting for 80%) in Huizhou from 2008 to 2011.The detection rates for CoxA16 and non-EV71,non-CoxA16 intestinal virus are 3.33% and 16.67% respectively.RT-PCR can be used for fast diagnosis of severe HFMD cases.Conducting pathogenic detection on children with HFMD below 5 years,screening for severe cases and treating them as soon as possible play key roles in HFMD prevention and control.