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目的明确2014年引起菏泽市手足口病(hand-foot-mouth disease,HFMD)的病原体型别及分布特征。方法采集临床诊断为HFMD病例的粪便或肛拭子样本,用实时荧光定量PCR方法进行人肠道病毒(human enterovirus,EV)71型、柯萨奇病毒A(Coxsackie virus A,CA)16型的核酸检测,并对结果进行分析。结果对533例临床HFMD病例样本检测,肠道病毒核酸阳性430例(80.68%)。其中EV71型阳性117例(27.21%),CA16型阳性181例(42.09%),EV71型和CA16型混合阳性7例(1.63%),其他肠道病毒型阳性125例(29.07%)。2—6月份肠道病毒阳性病例占全年阳性病例的63.49%,3月份为高峰。核酸阳性病例分布在各县区,五个县以CA16型流行为主,两个县以EV71型流行为主,两个县区以其他肠道病毒为主。1~3岁年龄人群最多(83.72%),男女性别比例为2.02。结论 2014年菏泽市HFMD病原体主要是CA16型肠道病毒,同时伴有EV71型和其他肠道病毒的流行,不同县区、月份和人群分布有差异。
Objective To clarify the types and distribution of pathogens causing hand-foot-mouth disease (HFMD) in Heze City in 2014. Methods Samples of feces or anal swab clinically diagnosed as HFMD were collected. The real-time fluorescence quantitative PCR method was used to detect human enterovirus (EV) 71, Coxsackie virus A (CA) 16 Nucleic acid detection, and analysis of the results. Results 533 cases of HFMD clinical samples were tested, and 430 cases of enterovirus nucleic acid positive (80.68%). Among them, 117 (27.21%) were positive for EV71, 181 (42.09%) were positive for CA16, 7 (1.63%) were positive for EV71 and CA16, and 125 were positive for other enteroviruses (29.07%). The positive cases of enterovirus in 2-6 months accounted for 63.49% of the positive cases in the whole year, the peak in March. The positive cases of nucleic acid were found in all counties and districts, with CA16 epidemic prevailing in five counties, EV71 epidemic in two counties and other enteroviruses in two counties. The population aged 1 to 3 years was the most (83.72%), the male-female ratio was 2.02. Conclusion In 2014, the major pathogens of HFMD in Heze city were CA16 type enterovirus, which was accompanied by the prevalence of EV71 and other enteroviruses. There were differences in distribution among different counties, months and populations.