山东省首例手足口病死亡病例调查与确认报告

摘要

Hand,foot and mouth disease is a common disease in the children under 5 years old,generally the prognosis is good,but if the treatment is not timely,it is easy to develop into severe and even death.On the fist July 2014,a death case was reported by Heze city,also the case was the first death case in Shandong province.In order to confirm the pathogen and cause of death on the first case of hand,foot and mouth disease,epidemiological investigation was applied, the family numbers of the patient and the doctors were interviewed,the medical records were collected.Finally,we knew that he went two village clinics successively,then he was sent to the city hospital for infectious diseases.Although the doctors tried their best to rescue the patient,he was dead for EV71 infection,with viral encephalitis and neurogenic pul-monary edema.We should focus on the medical case guidance,especially the rural areas,in order to reduce the severe morbidity and mortality.%手足口病是5岁以下幼儿的常见病，一般预后较好，但如果救治不及时易发展为重症，甚至死亡。2014年7月1日，菏泽市报告了一例手足口病死亡病例，该病例亦为山东省首例死亡病例。为了确认该病例的感染病原体和死亡原因，通过流行病学调查方法、询问患者家属及医务人员、查阅病例等方法了解到该病例先后在两家村级卫生室就诊，后转到市传染病医院，虽经极力抢救，仍因手足口病合并病毒性脑炎和神经源性肺水肿，呼吸、循环衰竭而死。经肛拭子标本实时定量PCR检测，该病例检测结果为EV71感染。应进一步加强手足口病的防控措施，重点关注对农村地区的病例指导时就医，降低手足口病的重症率和死亡率。