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目的了解2009-2013年济南地区重症手足口病(HFMD)病原及流行特征,为防控提供科学依据。方法对辖区哨点医院送检的138例重症HFMD病例标本,应用RT-PCR技术检测肠道病毒71型(EV71)、柯萨奇病毒A组16型(CVA16)、非EV71和CVA16的其它肠道病毒(EV);并采用描述流行病学方法对重症HFMD病例进行流行病学分析。结果 138例重症HFMD病例中,有132例感染了肠道病毒,阳性率为95.65%。其中感染EV71的有114例,占阳性病例的86.36%;感染CVA16的有9例(6.52%),感染其他EV的9例(6.52%)。HFMD重症病例呈散发,主要集中于5-8月份(74.64%),病例人群男性明显高于女性(χ2=48.75,P<0.01),其中3岁以下幼儿是重症病例发生主要年龄段(84.06%)。结论重症HFMD具有明显的人群特征,EV71是重症及死亡病例的主要病毒类型;应关注高危人群,早期识别重症并及时干预治疗是降低病死率的关键。
Objective To understand the etiopathogenisis and epidemic features of severe hand-foot-mouth disease (HFMD) in Jinan from 2009 to 2013 so as to provide a scientific basis for prevention and control. Methods A total of 138 severe HFMD cases were collected from sentinel hospitals in the area. RT-PCR was performed to detect the expression of enterovirus 71 (EV71), Coxsackievirus A (type 16A), non-EV71 and CVA16 (EV); and epidemiological analysis of severe HFMD cases using descriptive epidemiological methods. Results Of 138 cases of severe HFMD, 132 cases were infected with enterovirus, the positive rate was 95.65%. Among them, 114 were infected with EV71, accounting for 86.36% of the positive cases; 9 (6.52%) were infected with CVA16 and 9 (6.52%) were infected with other EVs. Severe HFMD cases were mainly distributed in May-August (74.64%). The incidence of HFMD was significantly higher in males than in females (χ2 = 48.75, P <0.01), of which children under 3 years old were the major age groups with severe cases (84.06% ). Conclusions Severe HFMD has obvious crowd characteristics. EV71 is the major virus type in severe and fatal cases. Attention should be paid to high-risk groups. Early identification of severe and timely intervention is the key to reduce mortality.