2008-2009年湖北省十堰市手足口病监测分析

Surveillance and analysis of hand,foot and mouth disease in Shiyan city,Hubei province,2008-2009

目的了解湖北省十堰地区手足口病的流行状况与病原动态分布变化,进一步优化检测方案,以探求该市手足口病的流行特征与防控对策。方法分析该市2008-2009年手足口病临床诊断病例的报告资料;收集十堰市233例手足口病病例的疱疹液或咽拭子标本,提取病毒RNA,以RT-PCR或荧光定量PCR进行核酸检测分型。结果手足口病全年均可在该市各地流行,病原以CA16和EV71型为主;时间分布:以5-7月为主;年龄分布:以<5岁散居或幼托儿童为主;检出率:疱疹标本明显高于咽拭标本,荧光定量PCR明显高于RT-PCR。结论该市各县(市、区)全年均不同程度出现以CA16和EV71型为主的手足口病流行,5-7月应重点加强对全市托幼机构手足口病的防控;建议采用以采集疱疹液为主、咽拭子为辅,用荧光定量PCR进行核酸检测的检测方案。

Objective To provide an overview of the prevalence and etiologic distribution of hand,foot and mouth disease（HFMD） in Shiyan,Hubei,and optimize the detection program,providing the basis for understanding of the epidemiological characteristics and development of control and prevention strategies of HFMD.Methods Clinical data of diagnosed HFMD cases from 2008 to 2009 were analyzed.Herpes samples and throat swabs were collected from 233 patients in the city for RNA extraction.RT-PCR or fluorescent quantitative real-time PCR were carried out for nucleic acid identification and typing.Results HFMD was prevalent in the city throughout the year.CA16 and EV71 were the predominant pathogens.The epidemic was mostly present from May to July,affecting mainly scattered children or kids in kindergartens aged less than 5 years.Higher detection rate was found in herpes samples than in swabs,and by fluorescent quantitative PCR than by RT-PCR.Conclusion Varying degrees of HFMD prevalence were present in multiple counties and districts of the city,with CA16 and EV71 the predominant pathogens.Prevention and control of HFMD should be strengthened for kindergartens in the city from May to July.It is highly recommended to collect suspects＇ herpes samples,or throat swabs as an alternative,for nucleic acid detection using fluorescent quantitative PCR.