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目的分析东莞市2010—2012年手足口病病原学特征和流行病学特征,为适时调整手足口病的防治方案提供参考资料。方法收集2010—2012年东莞市手足口病病原学监测标本、重症病例和聚集性疫情作为研究对象,用Realtime RT-PCR法对患者标本进行肠道病毒通用型、肠道病毒71型(EV 71)和柯萨奇病毒A组16型(Cox A16)的特异性核酸检测。结果共检测手足口病病例各类标本2 282份,肠道病毒通用型核酸阳性2 026份,检出率88.78%(2 026/2 282),其中,EV 71、Cox A16、EV 71和Cox A16混合感染、未分型类(即其他肠道病毒)的阳性病例分别占肠道病毒感染阳性的46.25%(937/2 026)、18.36%(372/2 026)、0.10%(2/2 026)和35.29%(715/2 026)。2010年东莞市HFMD病原以EV 71为主,构成比为60.63%(516/851),而2011和2012年HFMD病原主体是其他肠道病毒,其构成比为39.29%(211/537)和44.67%(285/638)。东莞市HFMD全年均有发病,高峰期主要为每年的4—6月(41.24%,941/2 282);男性发病例数(1 483例)多于女性(799例);病例以5岁以下儿童为主(92.73%,2 116/2 282)。分析2 026例肠道病毒阳性病例,其中轻、重症病例分别占所有病例的70.53%(1 429/2 026)、28.97%(587/2 026),死亡病例10例。重症病例以EV 71为主,其构成比为81.43%(478/587),死亡病例均为EV 71核酸阳性。结论2010年东莞市手足口病病原体以EV 71为主,2011年和2012年其他肠道病毒已经成为东莞市手足口病最主要的病原体。EV 71仍然是引起手足口重症和死亡病例的优势流行型别。
Objective To analyze the etiological and epidemiological characteristics of HFMD in Dongguan City from 2010 to 2012 and provide references for the prevention and control of HFMD. Methods To collect the surveillance samples, severe cases and epidemic outbreaks of HFMD in Dongguan City from 2010 to 2012 as the research object. Realtime RT-PCR was performed on the samples of patients with enterovirus universal, enterovirus 71 (EV 71 ) And Coxsackie A virus type 16 (Cox A16). Results A total of 2,282 samples of hand, foot and mouth disease were detected, 2 026 were positive for enterovirus, and the detection rate was 88.78% (2 026/2 282). EV 71, Cox A16, EV 71 and Cox A16, 46.25% (937/2 026), 18.36% (372/2 026) and 0.10% (2/2) of positive cases of enterovirus infection (ie, other enteroviruses) 026) and 35.29% (715/2 026). In 2010, the prevalence of HFMD in Dongguan was EV 71, with a composition ratio of 60.63% (516/851), while the main pathogens of HFMD in 2011 and 2012 were other enteroviruses with the constituent ratios of 39.29% (211/537) and 44.67 % (285/638). The incidence of HFMD in Dongguan was in the whole year, with the peak from April to June every year (41.24%, 941/282 2). The incidence of male HFMD was more than that of female (748 cases) The following children are predominant (92.73%, 2 116/2 282). Analysis of 2 026 cases of enterovirus positive cases, of which mild and severe cases accounted for 70.53% (1 429/2 026), 28.97% (587/2 026) of all cases, and 10 deaths. The major cases were EV 71, with a ratio of 81.43% (478/587). All the deaths were EV 71 nucleic acid positive. Conclusion The pathogens of hand-foot-mouth disease in Dongguan in 2010 are mainly EV 71. Other enterovirus in 2011 and 2012 have become the most important pathogens of hand-foot-mouth disease in Dongguan City. The EV 71 is still the prevalent type of illness that causes HFMD and deaths.