全州县2010年手足口病流行病学和病原学特征分析

Epidemiological and Etiological Characteristics of Hand,Foot and Mouth Disease in Quanzhou County,2010

目的分析全州县2010年手足口病(Hand,Foot and Mouth Disease,HFMD)的流行病学和病原学特征。方法采用描述流行病学方法,对国家疾病监测信息报告管理系统中报告的HFMD资料进行统计分析;对1例HFMD死亡病例和4例HFMD重症病例的肠道病毒71型(Enterovirus Type71,EV71),采用逆转录-聚合酶链反应(Reverse Transcription-Polymerase Chain Reaction,RT-PCR)扩增结构蛋白1(VP1)基因片段全长,并对扩增产物进行测序。根据VP1基因核苷酸序列与其他EV71毒株序列构建亲缘性关系树。结果截至2010年12月31日,全州县共报告HFMD 4580例,其中死亡10例;报告发病率651.15/10万,病死率为0.22%。0～5岁儿童病例占90.94%,其中2～3岁发病率15250.16/10万。实验室确诊HFMD 106例,其中EV71阳性77例;实验室确诊重症病例86例,EV71阳性62例。全州县5例HFMD的EV71 VP1基因序列测定和分析证实为C4a亚型。结论全州县2010年发生HFMD流行,重症病例发病高峰在4～6月,病例以<5岁儿童为主,2～3岁儿童发病率最高。EV71 C4a亚型为引起全州县HFMD重症和死亡的主要病原。

Objective To analyze the epidemiological and etiological characteristics of Hand, Foot and Mouth disease（HFMD）in Quanzhou county, Guangxi Province in 2010. Methods A descriptive epidemiological analysis was conducted based on the data of HFMD from the National Notifiable DiseaseReport System （NNDRS） ; The VPI coding gene of EV71 （Enterovirus Type 71, EV71 ） strains from clinical specimens of 1 death and 4 severe cases of HFMD was amplified by reverse transcription-polymerase chain reaction （RT-PCR） and sequenced. The homology and phylogenetic analyses were done between the 5 isolates and other EVn strains based on the sequence of VP1 gene. Results By 31 December, 2010, a total of 4580 HFMD cases including 10 death cases were reported. The reported morbidity was 651.15/100 000 and the fatality was 0.22%. 90.94% of the cases were 0-5 years old, and the morbidity of 2-3 years old children was 15 250.16/100 000. A total of 106 laboratory confirmed cases were reported, 77 of which were caused by EV71. A total of 86 laboratory confirmed severe cases were reported, 62 of which were caused by EV71.5 EV71 from Quanzhou county was confirmed to be subgenotype Caa by VPI sequences analysis. Conclusion HFMD occurred pandemic in Quanzhou county in 2010. The peak of severe cases was from April to June. Most cases reported were the children 〈 5 years old and the hightest morbidity of age group was in 2-3 years old. EVT1 of subgenotype C4- was the main pathogen for severe and death cases of HFMD in Quanzhou county.