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目的了解2012-2014年龙岩市手足口病病原学特征和流行病学特征,为龙岩市手足口病的防控提供病原学依据。方法用荧光RT-PCR方法对龙岩市各监测哨点医院送检的1 644例手足口病病例样本,进行肠道病毒核酸检测,并对检测结果进行统计描述和分析。结果 1 644例手足口病病例中,检出肠道病毒核酸阳性1 290例,阳性率为78.47%,其中EV71阳性290例,阳性率为17.64%;CoxA16阳性286例,阳性率为17.40%;未分型肠道病毒711例,阳性率为43.25%;EV71+CoxA16混合感染3例,阳性率为0.18%。重症病例以EV71为主;患者年龄11d~47岁,平均(2.37±1.92岁),患者主要为≤3岁幼儿,共1 115例,占86.43%,不同性别患者阳性率差异无统计学意义(χ2=2.29,P>0.05)。手足口病全年各月均可发病,具有明显的季节性,病例数主要集中在4~7月,占病例总数的44.40%。2012-2014年共报告重症病例26例,死亡1例,死亡病例病原体为EV71型。EV71为重症病例和死亡病例的主要病原体。结论 2012-2014年引起龙岩市手足口病的流行有明显的季节性,≤3岁幼儿为手足口病防控的重点人群,2012年手足口病病原构成以EV71为主,2013年和2014年手足口病病原构成发生变化,由其他肠道病毒占主导地位,因此应加强未分型样本的监测工作。
Objective To understand the etiological and epidemiological characteristics of HFMD in Longyan from 2012 to 2014 and provide etiological evidence for the prevention and control of HFMD in Longyan City. Methods A total of 1 644 cases of hand, foot and mouth disease were detected by fluorescence RT-PCR in all sentinel hospitals in Longyan City. The results were statistically analyzed and described. Results Among 1 644 HFMD cases, 1 290 positive cases of enterovirus nucleic acid were detected, the positive rate was 78.47%. The positive rate of EV71 was 290 cases, the positive rate was 17.64%. The positive rate of CoxA16 was 28.4%, the positive rate was 17.40%. 711 cases of undifferentiated enterovirus, the positive rate was 43.25%; EV71 + CoxA16 mixed infection in 3 cases, the positive rate was 0.18%. The major cases were EV71. The patients were 11 to 47 years old (average 2.37 ± 1.92 years). The patients were mainly ≤3 years old, a total of 1155 cases (86.43%). There was no significant difference in the positive rates among different sexes χ2 = 2.29, P> 0.05). Hand, foot and mouth disease can be affected throughout the year, with a clear seasonal, the number of cases mainly concentrated in April to July, accounting for 44.40% of the total number of cases. A total of 26 severe cases were reported in 2012-2014, 1 died and the pathogen of death was EV71. EV71 is the major causative agent of severe cases and deaths. Conclusion The prevalence of HFMD in Longyan City from 2012 to 2014 is obviously seasonal. The incidence of hand-foot-and-mouth disease (HFMD) in key children aged ≤3 years is the key population. In 2012, the prevalence of HFMD was EV71, and in 2013 and 2014 The composition of pathogens of hand-foot-mouth disease has changed, which is dominated by other enteroviruses. Therefore, monitoring of undivided samples should be strengthened.