论文部分内容阅读
目的了解2010年北京市某幼儿园手足口病聚集性疫情的流行病学特征及病原学特征。方法对本起疫情开展流行病学调查,分析每例患者感染来源,用描述流行病学特征方法进行分析。荧光定量RT-PCR方法检测肠道病毒71型(EV71)和柯萨奇病毒A组16型(Cox A16)。RD细胞进行病毒分离,对病毒分离株的VP1基因序列进行种系发生分析。结果某幼儿园某班手足口聚集性疫情7天内共发病6例,罹患率为31.6%,首发病例发病前接触过确诊的手足口患儿。其余患儿发病前和潜伏期的手足口患儿有密切接触。6例患儿中发热4例,占66.7%,在手、足、口腔、臀部均有疱疹,有2例被诊断为重症(构成比为33.3%),均出现脑炎和肺炎等并发症。其中6份咽拭子样本分离出2株EV71毒株(阳性分离率为33.3%)。VP1基因序列分析表明其与北京市2006-2010年EV71分离株核苷酸同源性为94.6%～100.0%。结论本起疫情由EV71毒株引起,EV71毒株VP1全长基因序列与北京市2006-2010年分离毒株具有较高同源性,未发生变异。该起疫情提示我们要加强手足口病的健康教育,提高各集体单位关于聚集性传染病的发现和报告能力,提高家长对手足口病的认识程度。
Objective To understand the epidemiological and etiological characteristics of HFMD epidemic in a nursery in Beijing in 2010. Methods An epidemiological investigation was conducted on the epidemic situation, the source of infection in each patient was analyzed, and the descriptive epidemiological characteristics were analyzed. Fluorescent quantitative RT-PCR was used to detect enterovirus 71 (EV71) and Coxsackie A group 16 (Cox A16). RD cells were subjected to virus isolation, and the VP1 gene sequence of the virus isolate was subjected to phylogenetic analysis. Results A kindergarten class hand, foot and mouth epidemic outbreaks within 7 days, a total of 6 cases, the attack rate was 31.6%, the first case before the onset of contact with the diagnosis of hand, foot and mouth children. The rest of the children before and during the incubation period of hand, foot and mouth children have close contact. Of the 6 children, 4 had fever, accounting for 66.7%. Herpes were found in the hands, feet, mouth and buttocks. Two cases were diagnosed as severe (33.3%), with complications such as encephalitis and pneumonia. Two EV71 strains were isolated from 6 throat swab specimens (positive rate was 33.3%). VP1 gene sequence analysis showed that the nucleotide homology with EV71 isolate of Beijing from 2006 to 2010 ranged from 94.6% to 100.0%. Conclusion The epidemic situation was caused by EV71 strain. The full-length gene sequence of EV71 strain VP1 shared high homology with the isolates from 2006 to 2010 in Beijing without any mutation. The outbreak shows that we need to step up health education on hand-foot-mouth disease and improve the ability of collective units to detect and report communicable diseases, so as to raise parents’ awareness of hand-foot-mouth disease.