2011年武汉及周边城市手足口病病原学及流行病学研究

摘要

Objective To find out more about the characteristics of aetiology and epidemiology of hand-foot-mouth disease(HFMD) and to provide laboratory data for epidemic control and patient care.Methods Throat swab samples were collected from 1844 cases of HFMD,and enterovirus(EV)71 and coxsackie virus A(CA) 16 were detected by real-time PCR.Results Among 1844 HFMD samples,20.2％ were infected with EV71,24.9％ with CA16 and 2.1％ cases with both.There were two high-incidence peaks of HFMD during 2011.One peak was from May to July,2011 when EV71 was the chief pathogen.The other was from Sept to Dec,2011,with CA16 as the chief pathogen.The peak incidence of HFMD appeared in the age groups of 1-3 years and most of them were from home.Boys outnumbered girls.Fever and central nervous system complications were significantly more frequent in patients with EV71 infection than those with CA16 infection.Conclusion HMFD in Wuhan and adjacent cities was mainly caused by EV71 and CA16 in 2011.Both were the main pathogens of the two seasonal peaks.A better knowledge of the composition of pathogens and characteristics of epidemiology plays an important role in the surveillance and control of HFMD.%目的 了解武汉市及周边城市2011年4月至2012年3月手足口病的病原学及流行病学特征,为本地区手足口病的防治提供依据.方法 采集手足口病患者咽拭子标本,采用实时荧光定量PCR方法检测肠道病毒71型(EV71)和柯萨奇病毒A16型(CA16)的核酸.结果 2011年4月至2012年3月共收集手足口病咽拭子标本1844例,其中EV71阳性372例,阳性率为20.2％；CA16阳性460例,阳性率为24.9％；EV71和CA16双阳性38例,阳性率为2.1％.在病例收集期间,武汉及周边城市暴发的手足口病有2个高峰期,第1个高峰期为2011年5～7月春末夏初季节,EV71亚型为主要病原体；第2个高峰期为2011年9～12月秋末冬初季节,CA16病毒为主要病原体；发病患者集中于1～3岁儿童,且男性明显多于女性；散居儿童人数明显多于幼托儿童；EV71亚型患者发热、中枢神经系统(呕吐、肢颤、嗜睡和惊厥)症状所占比例要显著高于CA16亚型.结论 2011年武汉市及周边城市2个手足口病高峰期的主要病原体分别是由EV71和CA16亚型引起的,及早了解手足口病病原体的构成及流行病学特征,对于其防控具有重要意义.