临沂市手足口病肠道病毒核酸检测及流行病学特征分析

Nucleic acid test of Enteroviruses in patients with hand-foot-mouth disease in Linyi and epidemiological analysis

目的调查临沂市手足口病患者并对其实验室检查结果进行统计,为手足口病的防治提供参考依据。方法选取临沂市报告的3621例手足口病患者,根据患者的年龄、性别、职业等分布进行分析,并对采集的样本进行肠道病毒核酸的RT-PCR检测。结果临沂市2010-2012年手足口病报告病例分别为490、1543、1588例,其中重症病例为3、8、14例,分别占0.61%、0.52%、0.88%;以3-6月份发病最多、最集中,2010年3-6月、2011年3-6月、2012年3-6月发病例数分别为393、1241、1356例,分别占全年发病数的80.2%、80.4%、85.4%;发病最多的在费县、临沭和河东,为985、607、564例,分别占27.20%、16.76%、15.58%;1～4岁发病人数为2568例,占70.9%;散居儿童发病人数2125例,占58.7%;病原学监测结果显示,2010年1月-2011年2月病原型别为EV71A基因型;2011年3月-2012年12月病原型别以EV71C4亚型和CA16为主。结论 2010年1月-2011年2月由EV71引起手足口流行,而2011年3月-2012年12月主要由EV71和CA16等肠道病毒引起手足口病流行,1～4岁儿童为易感人群。

OBJECTIVE To survey the patients with hand-foot-mouth disease（HFMD）in Linyi and statistically analyze the laboratory results so as to provide basis for the prevention and treatment of HFMD.METHODS The data of 3621 patients with HFMD reported in Linyi was collected and analyzed by starting from the distribution of age,gender,and profession,then the collected samples were tested for then ucleic acid of enteroviruses by RTPCR.RESULTS The number of the reported patients with HFMD in Linyi was 490 cases in 2010,1543 cases in 2011,and 1588 cases in 2012,among which there were 3 severe cases in 2010,8 cases in 2012,and 14 cases in 2012,accounting for 0.61%,0.52%,and 0.88%,respectively.The incidence of HFMD was the highest during the period from Mar to Jun,there were 393（80.2%）cases during Mar through Jun 2010,1241（80.4%）during Mar through Jun 2011,and 1356（85.4%）cases during Mar through Jun 2012.This disease was the most prevalent in Feixian,Linshu,or East district,where 985（27.20%）cases,607（16.76%）cases,and 564（15.58%） cases occurred.There were 2568（70.9%）cases of patients aged between one and four years old;there were 2125（58.7%）cases of scattered children.The etiological examination result indicated that the EV71A was the main genotype of Enteroviruses during Jan 2010 through Feb 2011,and that the EV71 and CA 16 were predominant during Mar 2011 through Dec 2012.CONCLUSIONThe epidemic of HFMD is caused by EV71in Linyi from Jan 2010 to Feb 2011,however,it is caused by EV71and CA 16 and the other enteroviruses from Mar 2011 to Dec 2012.The children aged between one and four years old are the susceptible population for HFMD.