疑似重症手足口病病原学检测及流行病学分析

Severe hand foot and mouth disease(HFMD)suspected pathogen detection and epidemiological analysis

目的：对2010年上海市手足口病哨点医院-复旦大学附属儿科医院送检的疑似重症手足口病病例样本进行实验室检测分析,从而为本地区手足口病的综合防治提供参考资料。方法：收集2010年哨点医院-复旦大学附属儿科医院疑似重症手足口病病例送检的咽拭、粪便、肛拭样本,应用real tim e RT-PCR技术检测肠道病毒7 l型（EV71）、柯萨奇病毒A组16型（CVA l6）、肠道病毒通用型（EV）。结果：832份不同类型的样本中,粪便样本的检测阳性率最高,咽拭最低,两者阳性检出率有显著性差异（P〈0.01）。431例疑似重症手足口病病例中,EV71病毒、CVA l6病毒、非EV71和非CVA l6的EV病毒阳性率分别为：81.90%、5.10%、6.03%;病例人群男性高于女性（1.80：1）,1岁~4岁年龄段病例数最多,5月-7月为高发月份。结论：EV71型是2010年本地区手足口病流行的主要致病病毒类型,其流行具有明显的年龄、季节界限。

Objective：To investigate the etiological agents of the outbreak of hand-foot-mouth disease（HFMD） in Shang hai area in 2010,so as to provide evidence for the prevention and management policy of this disease.Methods： Specimens including stools,throat swabs and anal swabs were collected from severe patients suspected of HFMD from surveillance hospital-Children′s hospital of fudan university.The specimens were detected by real time RT-PCR with the three typese of viruses including enteroviruse 71（EV71）,Coxasckie viruseA16（CVAl6） and the enteroviruse excluding EV71 and CVAl6（EV）.Results： 832 specimens collected from 431 patients,the positive rate of pan-enterovirus,EV71,CVA16 and EV were 81.90%,5.10% and 6.03%.There was a significant difference of the positive rate between the stools and the throat swabs（P0.01）.From the difference 0f age and gender,the male was more than female for HFMD（1.80：1）,and the incidence was the highest for 1 to 4 years old children.Conclusion： EV71 were the major etiological agents of the HFMD outbreak in Shang hai area in 2010,and the prevalence has obvious age,season limit.