2009-2013年济南地区重症手足口病病原学及流行病学分析

Analysis on etiology and epidemiology of severe hand,foot and mouth disease in Jinan region in 2009-2013

目的了解2009-2013年济南地区重症手足口病(HFMD)病原及流行特征,为防控提供科学依据。方法对辖区哨点医院送检的138例重症HFMD病例标本,应用RT-PCR技术检测肠道病毒71型(EV71)、柯萨奇病毒A组16型(CVA16)、非EV71和CVA16的其它肠道病毒(EV);并采用描述流行病学方法对重症HFMD病例进行流行病学分析。结果 138例重症HFMD病例中,有132例感染了肠道病毒,阳性率为95.65%。其中感染EV71的有114例,占阳性病例的86.36%;感染CVA16的有9例(6.52%),感染其他EV的9例(6.52%)。HFMD重症病例呈散发,主要集中于5-8月份(74.64%),病例人群男性明显高于女性(χ2=48.75,P<0.01),其中3岁以下幼儿是重症病例发生主要年龄段(84.06%)。结论重症HFMD具有明显的人群特征,EV71是重症及死亡病例的主要病毒类型;应关注高危人群,早期识别重症并及时干预治疗是降低病死率的关键。

Objective To investigate the etiological and epidemiological characteristics of severe hand, foot and mouth disease （HFMD） in Jinan region in 2009 - 2013 m as to provide scientific evidence for HFMD prevention and control. Methods RT - PCR technique was used to detect enterovirus 71 （EV71）, coxsackievirus A16 （CVA16） and other enteroviruses in 138 specimens collected from severe HFMD cases in the sentinel hospital. All the data of severe HFMD cases were analyzed by descriptive epidemiological method. Results Among 138 severe HFMD cases, 132 （95.65 % ） were positive for EV RNA, of which 86.36% （114/132） were positive for EV71, 6.52% （9/132） positive for CVA16 and 6.52% （9/132） positive for other entero- viruses. All of the severe HFMD cases were sporadic, and 74.64 % of the cases occurred between May and August. Male cases of severe HFMD were significantly more than females ones （ χ^2= 48,75, P 〈 0.01 ）, and 84.06 % of the severe HFMD cases were children aged less than 3 years. Conclusions The severe HFMD cases show obvious population characteristics, and EV71 is the main pathogen for severe or dead HFMD cases in Jinan region during 2009 2013. It is necessary to pay more attention to the high - risk population, and the early recognition and timely intervention and treatment of severe cases are the keys to reducing the mortality rate.