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目的了解广东省2010—2013年手足口病的病原学特征及变化趋势,为手足口病防治工作提供参考依据。方法 2010年3月至2013年12月在广州、深圳、肇庆等8个市各选取1家儿童医院(妇幼保健院、综合性医院儿科)作为监测哨点,对监测哨点符合监测病例定义的患者采集样本进行肠道病毒检测。结果 8个监测哨点共采集手足口病轻症病例样本6 816份,检出肠道病毒阳性5 403份,总阳性率为79.27%;各型别肠道病毒检出率分别为肠道病毒71型(EV 71)25.57%、柯萨奇病毒A16型(Cox A16)17.31%、其他肠道病毒36.38%。2010年EV 71阳性率最高,为37.73%(506/1 341);2011年和2013年其他肠道病毒阳性率最高,分别为30.83%(508/1 648)和60.60%(1 055/1 741);2012年EV 71和其他肠道病毒阳性率几乎持平,分别为29.53%(616/2 086)和29.34%(612/2 086)。2010―2012年,广东省手足口病流行的优势病原体在4―5月和9―10月发生变换,优势病原体的变换时间与手足口病发病的春夏季高峰和秋季高峰基本一致或者提前1~2周。2013年1―10月的优势病原体均为其他肠道病毒,全年手足口病发病仅有1个高峰。结论广东省2010―2013年手足口病流行的优势病原体呈现出EV 71、Cox A16和其他肠道病毒频繁变换的特点,提示长期连续的监测掌握病原体变化规律和病毒变异情况对于手足口病的早期预警和预防控制具有重要意义。
Objective To understand the etiological characteristics and trends of hand-foot-mouth disease in Guangdong Province from 2010 to 2013 and provide a reference for the prevention and treatment of hand-foot-mouth disease. Methods From March 2010 to December 2013, 1 children’s hospital (MCH and general hospital pediatrics) were selected as the sentinel sites in 8 cities of Guangzhou, Shenzhen and Zhaoqing, respectively. The sentinel surveillance sites were defined according to the surveillance cases Patients collected samples for enterovirus detection. Results A total of 6 816 samples of mild to moderate hand-foot-mouth disease were collected from 8 monitoring sentinels, and 5 403 were positive for enterovirus, the total positive rate was 79.27%. The detection rates of enterovirus in each type were enterovirus 25.57% of 71 (EV 71), 17.31% of Cox A16 and 36.38% of other enteroviruses. The highest positive rate of EV 71 in 2010 was 37.73% (506/1 341). The positive rates of other EVs in 2011 and 2013 were the highest (30.83% (508/1 648) and 60.60% (1055/1 741 ). The positive rates of EV 71 and other enterovirus infections in 2012 were almost the same at 29.53% (616/2 086) and 29.34% (612/2 086), respectively. From 2010 to 2012, the predominant pathogen of HFMD in Guangdong province changed from April to May and from September to October. The transition time of the dominant pathogen was basically the same as the peak of spring, summer and fall of HFMD, or 1 ~ 2 weeks. The predominant pathogens from January to October 2013 were all other enteroviruses, with only one peak incidence of hand-foot-mouth disease in the whole year. Conclusion The predominant pathogens of HFMD in Guangdong Province during 2010-2013 showed the frequent transformation of EV 71, Cox A16 and other enteroviruses, suggesting long-term continuous monitoring of the variation of pathogens and the variation of viruses. In the early stage of hand-foot-mouth disease Early warning and prevention and control are of great significance.