2013—2014年淮安市手足口病病原学分析

Etiology analysis of hand-foot-mouth disease in Huai'an City from 2013 to 2014

目的了解2013—2014年淮安市手足口病流行特征,为手足口病防控提供病原学依据。方法收集淮安市各县区疾病预防控制中心采集的950例疑似手足口患者的咽拭子和肛拭子标本,采用Real time RT-PCR方法对通用肠道病毒(EV)、肠道病毒71型(EV71)、柯萨奇病毒A组16型(CA16)的核酸进行检测。结果 950份临床标本中,共检出手足口病阳性标本347份,总阳性率为36.5%。其中EV71型阳性率为15.5%、CA16型阳性率为11.4%、其他EV型阳性率为9.7%。男性阳性率为36.2%,女性阳性率为37.0%,差异无统计学意义(P>0.05)。重症病例感染病原以EV71为主。发病3 d内采集标本的肠道病毒检出率高于发病3 d后采集的标本,差异有统计学意义(P<0.01)结论淮安市手足口病主要病原以EV71型、CA16型及其他EV型混合为主,其中EV71为优势型,定期开展手足口病病原学监测有助于做好防控工作。

Objective To understand the epidemic characteristics of hand-foot-mouth disease(HFMD) in Huai’an City from 2013 to 2014, so as to provide the etiological evidence for prevention and control of HFMD. Methods The specimens of the throat swabs and anal swabs of 950 patients with HFMD were collected in Huai’an City and the clinical specimens were detected for general enterovirus(EV), enterovirus 71(EV71), and coxsackievirus A16(CA16) with RT-PCR.Re-sults There were 347 enterovirus samples among the total 950 clinical specimens, and the positive rate was 36.5%,and among which, the rates of EV71, Cox A16 and other types of enterovirus were 15.5%, 11.4% and 9.7% respectively. As for different genders, the enterovirus positive rate of males was 36.2%, and the rate of females was 37.0%, there was no statistical significance of the difference(P>0.05). EV71 was the main pathogen type in severe cases. The positive rate of specimens collected from the onset within 3 days was higher than that over 3 days, and there was a statistical significance of the difference(P<0.01). Conclusion The main pathogen of HFMD is mixture of EV71, CA16 and other types of EV, and the major pathogen is EV71 in Huai’an City. The regular surveillance of epidemiology and etiology of HFMD is helpful to the prevention and control of HFMD.