2015年上半年南昌地区9020例手足口病病原结构及临床特征

Pathogenic Structures and Clinical Features of Hand-Foot-Mouth Disease in Nanchang in the First Half of 2015:An Analysis of 9020 Cases

目的分析南昌地区手足口病(hand-foot-mouth disease,HFMD)流行特点、病原分布与临床特征,为本地区HFMD的防控提供依据。方法采集9020例HFMD病例咽拭子标本,应用荧光PCR法进行肠道病毒71型(enterovirus 71,EV71)、A组16型柯萨奇病毒(coxsackievirus A 16,CA16)和肠道病毒通用型(universal enteroviruses,EU)检测,对其中2024例住院治疗的HFMD患儿临床资料进行比较分析。结果 2015年1—6月,南昌地区HFMD发病高峰期为5—6月,发病年龄集中在3岁以下,男女=2.021。9020例咽拭子标本检测结果阳性总数为9904例次;其中,EU阳性7203例次(72.73%);EV71阳性1156例次(11.67%);CA16阳性1545例次(15.60%)。2024例住院HFMD咽拭子检测结果阳性总数为2749例次,EV71阳性病例中重型、危重型比例[48.9%(248/507)]明显高于CA16阳性病例[15.6%(34/219)]及EU阳性病例[37.0%(748/2023)](均P<0.001)。CA16阳性病例中的普通型比例[84.5%(185/219)]明显高于EV71阳性病例[51.1%(259/507)]及EU阳性病例[63.0%(1275/2023)](均P<0.001)。结论 2015年上半年南昌地区HFMD发病年龄多集中在3岁以下,发病高峰期为5—6月。EU为主要病原体,EV71在重症HFMD病例中占主要地位。

Objective To analyze the epidemic characteristics,pathogen distribution and clinical characteristics of hand-foot-mouth disease(HFMD)in Nanchang,and to provide a basis for the prevention and control of HFMD.Methods Fluorescence PCR was used to detect enterovirus 71(EV71),coxsackievirus A 16(CA16)and universal enterovirus(EU)in throat swab specimens collected from 9020 children with HFMD,and the clinical data of 2024 hospitalized children were analyzed.Results In the first half of 2015,the peak of HFMD cases in Nanchang was observed from May to June.Most children had onset below the age of 3 years and the ratio of male to female was 2.02[BFZ]:[BFB]1.Of the 9020 specimens,the positive results were found in 9904 case times,including 7203 EU-positive specimens(72.73%),1156 EV71-positive specimens(11.67%),and 1545 CA16-positive specimens(15.60%).Among the 2024 hospitalized children,the positive results were observed in 2749 case times.The proportion of moderate or severe HFMD children in EV71-positive cases(48.9%,248/507)was higher than that in CA16-positive cases(15.6%,34/219)and that in EU-positive cases(37.0%,748/2023)(P<0.001).The proportion of common HFMD in CA16-positive cases(84.5%,185/219)was higher than that in EV71-positive cases(51.1%,259/507)and that in EU-positive cases(63.0%,1275/2023)(P<0.001).Conclusion In the first half of 2015,HFMD mostly occurred in children less than 3 years of age with a peak from May to June in Nanchang.The EU was the main pathogen of HFMD,and EV71 was the dominant agent in severe cases.