2012-2013年深圳市南山区手足口病原学及初发临床症状分析

The analysis of the composition of microbial pathogens cansed to HFMD and the different onset clinical symptoms of HFMD during 2012-2013 in Nanshan District

目的分析2012年和2013年1月至11月期间引起深圳市南山区手足口病的病原组成情况以及不同病原引起的临床症状的差异,及早了解手足口病病原最新的流行情况,科学预防病原变异,并通过比较手足口病初发时临床症状,预测疾病的发展趋势,以期预防手足口病重症的发生。方法分析2012年和2013年1月至11月本区采集的手足口病集中爆发疫情中的病原检测资料和流行病学调查资料,总结疫情暴发情况与季节的关系和由不同病原引起的临床症状。结果不同病原在不同季节的流行情况不同,EV71和CoxA16主要在1～6月流行,除这两病毒外的其它肠道病毒主要在4～12月流行,其中4～6月感染的病例数最多。而不同病原引起的临床症状差异,最主要表现为由EV71和CoxA16引起的症状轻微的手足口病很少出现发热和咽炎,而除这两种病毒外的肠道病毒引起的手足口病表现为发热、咽炎和咳嗽。结论由非EV71非CoxA16的肠道病毒感染的87.0%的病例出现咽炎,本区非EV71非CoxA16的肠道病毒阳性病例很可能感染的是CoxA 6,相关证实及研究正在进行中。

Objective To understand the current prevalence status of Hand-foot-and-mouth disease （HFMD）outbreaks and to prevent the mutation of pathogens, though the study of composition of microbial pathogens has caused HFMD,and the differences in the clinical symptoms caused by different pathogens, in Nanshan District, Shenzhen during 2012- November 2013, and by comparing early clinical symptoms of Hand-foot-and-mouth disease, to forecast of HFMD’s prevalence trend, and to prevent the occurrence of severity in children with HFMD.Methods Analysis of pathogen detection data and epidemiological data of local outbreaks of HFMD during 2012- November 2013, summary of seasonal outbreaks, correlation with seasons and the clinical symptoms caused by different pathogens. Results HFMD has changed its prevalence in different pathogens and different seasons, a major epidemic of EV71 and CoxA16 occurred during January-June, others enteroviruses was presented in April-December. The maximum number of cases of infections was diagnosed from April to June. The differences of clinical symptoms caused by different pathogens, The HFMD cases with mild symptoms were caused mainly by EV71 and CoxA16, mild fever and pharyngitis rarely occurs. All enteroviruses infections except these two can cause fever, pharyngitis and cough. Conclusion By not EV71 CoxA 16 87.0 % of enterovirus infection cases of pharyngitis, this area not EV71 CoxA16 of intestinal virus positive cases of infection is probably CoxA 6, relevant proof and research is under way.