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目的了解武汉市及周边城市2011年4月至2012年3月手足口病的病原学及流行病学特征,为本地区手足口病的防治提供依据。方法采集手足口病患者咽拭子标本,采用实时荧光定量PCR方法检测肠道病毒71型(EV71)和柯萨奇病毒A16型(CA16)的核酸。结果 2011年4月至2012年3月共收集手足口病咽拭子标本1844例,其中EV71阳性372例,阳性率为20.2%;CA16阳性460例,阳性率为24.9%;EV71和CA16双阳性38例,阳性率为2.1%。在病例收集期间,武汉及周边城市暴发的手足口病有2个高峰期,第1个高峰期为2011年5～7月春末夏初季节,EV71亚型为主要病原体;第2个高峰期为2011年9～12月秋末冬初季节,CA16病毒为主要病原体;发病患者集中于1～3岁儿童,且男性明显多于女性;散居儿童人数明显多于幼托儿童;EV71亚型患者发热、中枢神经系统(呕吐、肢颤、嗜睡和惊厥)症状所占比例要显著高于CA16亚型。结论 2011年武汉市及周边城市2个手足口病高峰期的主要病原体分别是由EV71和CA16亚型引起的,及早了解手足口病病原体的构成及流行病学特征,对于其防控具有重要意义。
Objective To understand the etiology and epidemiology of hand, foot and mouth disease from April 2011 to March 2012 in Wuhan and surrounding cities, and to provide basis for the prevention and treatment of HFMD in this area. Methods Throat swabs were collected from patients with hand-foot-mouth disease, and the nucleic acids of enterovirus 71 (EV71) and Coxsackie virus A16 (CA16) were detected by real-time fluorescence quantitative PCR. Results A total of 1844 throat swabs were collected from April 2011 to March 2012, of which 372 were EV71 positive, the positive rate was 20.2%. The positive rate of CA16 was 460, with a positive rate of 24.9%. EV71 and CA16 were both positive 38 cases, the positive rate was 2.1%. During the collection of cases, hand-foot-mouth disease outbreaks in Wuhan and surrounding cities had two peak periods. The first peak period was spring, early summer and early summer from May to July in 2011, with the EV71 subtype as the main pathogen. The second peak The CA16 virus was the main pathogen during the autumn-winter early September and December of 2011. The incidence of the disease was concentrated in children aged 1-3 years with significantly more males than females; the number of scattered children was significantly higher than that of children with preschool children; the patients with EV71 subtype had fever , Central nervous system (vomiting, limbs, drowsiness and convulsions) symptoms were significantly higher than the proportion of CA16 subtype. Conclusions The major pathogens of HFMD during the peak period of HFMD in Wuhan and surrounding cities in 2011 are caused by EV71 and CA16 subtypes respectively. It is important to understand the composition and epidemiological characteristics of HFMD pathogens as early as possible .