疑似重症手足口病病原学检测及流行病学分析

Pathogen detection and epidemiological analysis of suspected severe hand-foot-mouth disease(HFMD)

目的对2011年山东省滨州市采集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。方法采集2011年滨州市366例疑似重症手足口病病例的咽拭、粪便、肛拭样本，应用realtime RT—PCR技术检测肠道病毒71型（EV71）、柯萨奇病毒A组16型（CVA16）、肠道病毒普通型（EV）。结果707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（P〈0．01）。366例疑似重症手足口病病例中，EV71病毒、CVA16病毒、非EV71和非CVA16的EV病毒阳性率分别为81．42％、4．64％、5．74％；病例人群男性高于女性（1．49：1），1岁-4岁年龄段病例数最多，5月-7月份为高发月份。结论EV71型是2011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、季节性。

Objective To investigate the etiological agents of the outbreak of hand - foot - mouth disease （HFMD） in Binzhou area in 2010, so as to provide evidence for prevention and control of this disease. Methods Specimens including stools, throat swabs and anal swabs, were collected from suspected severe HFMD patients from Binzhou city. The specimens were detected by real time RT -PCR for enterovirus 71 （EV71）, Coxasckie virus A16 （CVA16） and the enterovirus excluding EV71 and CVA16 （EV）. Results Among 707 specimens from 366 patients, the positive rates of pan - enterovirus, EV71, CVA16 were 81.42%, 4.64% and 5.74%. There was a significant difference of the positive rate between the stools and the throat swabs （P 〈 0.01 ）. From the difference of age and gender, the male was more than female for HFMD （1.49：1） , and the incidence was the highest for 1 -4 years old children. Conclusion EV71 was the main etiological agents of the HFMD outbreak in Binzhou city in 2011, and the prevalence has obvious age and season limit.