广州市一起手足口病死亡病例的调查与确认

The first confirmed death case of hand-foot-mouth diease in Guangzhou

目的确认2008年5月广州市番禺区1起婴儿手足口病死亡的病因。方法访谈病例发病前后相关知情人,查阅临床病志,对病家开展现场调查和病例主动搜索。采集病例肛拭子、口腔分泌物、鼻腔分泌物、脑脊液,应用逆转录-聚合酶链反应(RT-PCR),检测肠道病毒(EV)的EV71和CA16特异的核酸片段。结果患儿无外出,无接触史,病家及周围卫生条件差。5月1日,患儿发热,手、足及口腔出现散在疱疹,5月5日,出现抽搐、巴氏症阳性、双肺可闻及大量痰鸣音等重症表现,死于脑炎和肺水肿。实验室结果为EV71阳性、Cox A16阴性。结论该患儿为7EV71感染的重症手足口病例,但感染途径未查明。

Objective To confirm one case of baby hand, foot and mouth disease causes the death of ways in May 2008 in Panyu District, Guangzhou City. Methods before and after the onset cases related to insiders was interviewed and medical redcords were collected, site investigations and cases of active search were conducted to the case and his house- holds. Acquisition cases anal swabs, oral secretions, nasal secretions, cerebrospinal fluid, reverse transcriptase - polymerase chain reaction （ RT - PCR）, detection of the EV71 and Cox A16 - specific DNA fragment. Results The results in children with no bail, no history of exposure, the case to his households and the surrounding poor sanitation, children had fever, hand, foot and oral herpes in a casual, in May 1, and a convulsion, Pakistan＇s disease positive, lungs can hear the sound - ruing and a large quantity of sputum, such as severe performance, in May 5, died of encephalitis and lung Edema. EV71 positive laboratory results, CoxA16 negative. Conclusion The EV71 infection for children with severe cases of hand, foot and mouth, but did not identify means of infection.