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目的分析安康市2010-2012年重症手足口病流行病学特点,为进一步预防和控制手足口病提供科学依据。方法对2010-2012年安康市报告的所有重症手足口病病例进行个案调查和样品采集,用RT-PCR法对患者标本进行总肠道病毒、肠道病毒71型(EV 71)和柯萨奇病毒A组16型(Cox A16)的特异性核酸检测。结果 2010-2012年安康市共报告手足口病病例5 998例,年均报告发病率为74.72/10万,其中重症病例52例,死亡1例。重症病例主要集中在4~7月和11~12月,年龄主要集中在3岁以下儿童(占78.85%),居住地为农村的40例(76.92%);从发病到初次就诊平均时间0.54 d,从发病到诊断为重症2.86 d;初次就诊者32例未诊断出手足口病,村(个体)诊所和乡镇(社区)医院占81.26%;临床表现以发热和皮疹为主;实验室EV 71检测率为42.31%,其他肠道病毒检测率为9.62%,Cox A16检测率为1.92%。结论加强基层培训、改善农村的环境卫生、加强疾病的监测、做好重症手足口病救治工作是防治重症手足口病的关键。
Objective To analyze the epidemiological characteristics of severe hand-foot-mouth disease in Ankang City from 2010 to 2012 and provide a scientific basis for further prevention and control of hand-foot-mouth disease. Methods All cases of severe HFMD reported in Ankang City from 2010 to 2012 were collected for case investigation and sample collection. The total enterovirus, EV 71 and Coxsackie Virus A Group 16 (Cox A16) specific nucleic acid detection. Results A total of 5 998 HFMD cases were reported in Ankang City from 2010 to 2012, with an average annual incidence of 74.72 / 100 000, of which 52 were severe cases and 1 died. The main cases of severe cases were from April to July and from November to December. The age was mainly concentrated in children under 3 years old (78.85%), and 40 (76.92%) were in rural areas. The average time from onset to first visit was 0.54 days , From the onset to the diagnosis of severe 2.86 d; the first visit of 32 cases were not diagnosed hand, foot and mouth disease, village clinics and township (community) hospitals accounted for 81.26%; clinical manifestations of fever and rash; laboratory EV 71 The detection rate was 42.31%, the detection rate of other enterovirus was 9.62% and the detection rate of Cox A16 was 1.92%. Conclusion Strengthening grassroots training, improving sanitation in rural areas, strengthening disease surveillance, and doing a good job in the treatment of severe hand-foot-mouth disease are the keys to preventing and treating severe hand-foot-mouth disease.