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目的分析2011-2015年广州市手足口病流行病学特征情况,了解引起手足口病的常见病原及其他肠道病毒的特征,为不同型别手足口病病例监测和防控提供参考依据。方法收集广州市2011年1月1日-2015年12月31日各哨点监测医院的疑似手足口病病例及疑似暴发疫情标本,使用实时荧光定量聚合酶链反应法检测病毒核酸。结果5年内共采集疑似及确诊病例的粪便、肛拭子或疱疹液等标本共12 108份,检测总阳性例数有8 922例(73.69%,8922/12 108);2014及2015年发病率最高;其他肠道病毒检出率为35.19%,Cox A16和EV71混合感染112份。广州市每年的4~8月为手足口病的高发期,11月开始又形成一个小次高峰。0~5岁组确诊为手足口病患者的人数最多,共4 262例,该年龄组中EV71、Cox A16的男性患者均比女性多。在手足口病的高发季节,2011-2012,2013-2014年手足口病病原以EV71为主,但在2012-2013,2014-2015年,同样在手足口的高发季节,EV71和Cox A16相比其他年份均出现下降,而其他肠道病毒所占比例呈现明显上升。结论广州地区手足口病的高发期为每年的4~8月,5岁以下儿童更易感染,EV71和Cox A16仍是手足口病的主要病原,在高发期还要加强对其他肠道病毒的检测,掌握病原的流行规律,以分析手足口病病原谱的变化。
Objective To analyze the epidemiological characteristics of HFMD in Guangzhou from 2011 to 2015 and to find out the common pathogens and other enteroviruses that cause HFMD and to provide reference for the surveillance and prevention and control of HFMD in different types. Methods From January 1, 2011 to December 31, 2015, samples of suspected hand-foot-and-mouth disease and suspected outbreak in each sentinel surveillance hospital were collected and detected by real-time fluorescence quantitative polymerase chain reaction (RT-PCR). Results A total of 12 108 samples of feces, anal swab or herpes fluid in suspected and confirmed cases were collected in 5 years. A total of 8 922 positive samples (73.69%, 8922/128) were detected. The incidence rates in 2014 and 2015 The highest detection rate of other enteroviruses was 35.19% and 112 were mixed with Cox A16 and EV71. The annual incidence of hand-foot-mouth disease in Guangzhou from April to August is also a small peak in November. The number of patients diagnosed with hand-foot-mouth disease in the 0-5 age group was the highest (4 262 cases), with more men than EV71 and Cox A16 in this age group. In the high season of hand, foot and mouth disease, EV71 was the main cause of HFMD in 2011-2012 and 2013-2014, but in 2012-2013 and 2014-2015, EV71 and Cox A16 were also higher in hand-foot-mouth high season Other years showed a decline, while the proportion of other enterovavirus showed a significant increase. Conclusion HFMD in Guangzhou area is frequently occurring from April to August every year. Children under 5 years of age are more susceptible to infection. EV71 and Cox A16 are still the major pathogens of hand-foot-mouth disease. In the high incidence period, the detection of other enteroviruses should be strengthened , Master the epidemic of pathogen, to analyze changes in the spectrum of hand-foot-mouth disease.