石家庄市2009年-2012年手足口病监测病原学分析

Etiology analysis of hand-foot-and-mouth disease in Shijiazhuang from 2009 to 2012

目的分析石家庄市2009年-2012年手足口病的病原学特征,为手足口病防控提供依据。方法在全市24个县(市/区)采集的手足口病(HFMD)患者临床标本,采用RT-PCR或Real time RT-PCR的方法对通用肠道病毒(EV)、肠道病毒71型(EV71)和柯萨奇病毒A16型(CA16)特异核酸进行检测。结果 3360份临床标本中,检出肠道病毒阳性样品2699份,EV71与CA16合计2274份,检出率67.68%;2009年与2012年主要流行病原为CA16,2010年与2011年为EV71;同一年份,24个县(市/区)的病原构成不同;不同年份,同一县(市/区)病原构成不同;重症病例和死亡病例感染病原以EV71为主。结论石家庄市HFMD的病原构成和流行规律复杂,防控难度较大。需持续加强对不同县(市/区)HFMD的流行病学与病原学监测,采取有针对性的防控措施,有效控制HFMD的流行。

Objective To reveal the pathogenic characteristics of hand - foot - and - mouth disease in Shijiazhuang from 2009 to 2012, so as to provide basis for prevention and control of HFMD. Methods Clinical specimens were collected from HFMD patients to detect the enterovirus （ Enterovirus （ EV） , human enterovirus71 （ EV7 1 ）, coxsackie virus A 16 （ CA 16 ） ） with RT - PCR or Real time RT - PCR. Results There were 2699 enterovirus samples in 3360 clinical specimens, and 2274 specimens were EV71 and CA16, accounting for 67.68% ; In 2009 and 2012, CA16 was the main epidemic pathogen in Shijiazhuang, and EV71 took the place in 2010 and 2011 ; In the same year, pathogen composition varied among 24 counties. And in the same county, pathogens altered with the years; EV71 was the main pathogen type in severe and death cases. Conclusion The pathogen types and epidemic regularity of HFMD are complex in Shijiazhuang, which increases the difficulty in preventing and controlling. It is highly necessary to strengthen the surveillance on epidemiology and etiology of HFMD all over the counties, and take pertinence measures to control the epidemic of HFMD effectively.