湖南省2008年手足口病流行病学特征分析  

Analysis on epidemiologic feature of hand-foot-mouth disease(HFMD) in Hunan province in 2008

作　　者：高立冬[1] 陈长[1] 胡世雄[1] 张红[1] 王五红[1] 李俊华[1] 刘富强[1] 

机构地区：[1]湖南省疾病预防控制中心,湖南长沙410005

出　　处：《中国现代医学杂志》2010年第21期3278-3281,3285,共5页China Journal of Modern Medicine

摘　　要：目的分析湖南省2008年手足口病疫情流行病学特征,明确手足口病病原体主要型别,为制定预防控制措施提供依据。方法采用描述性流行病学方法分析疫情三间分布特征;采集手足口病临床诊断病例的疱疹液、咽拭子、肛拭子、粪便等标本,应用RT-PCR方法检测原始样本和分离阳性毒株中的EV、EV71和CoxA16病毒的核酸,用RD、Hep-2细胞对粪便标本进行病毒分离。结果湖南省2008年共报告27 133例手足口病病例,死亡11例,报告发病率为42.66/10万;全年每月均有病例报告,其中5～7月为发病高峰。病例广泛分布于全省121个县市区,以散发为主。病例男女性别比1.81∶1;以5岁以下年龄组儿童为主,占总病例数的89.43%,其中3岁以下(含3岁)年龄组儿童占总病例数的79.33%。采集了标本的719例病例中,肠道病毒检出阳性率为42.56%,其中EV71阳性者占总阳性的78.10%,且一般(轻症)病例肠道病毒检出阳性率(42.11%)与重症和死亡病例肠道病毒检出阳性率(51.43%)差异无统计学意义(χ2=1.18,P=0.28),但一般(轻症)病例中EV71病毒检出阳性率(32.31%)与重症和死亡病例EV71病毒检出阳性率(51.43%)差异有统计学意义(χ2=5.48,P=0.02)。病例咽拭子、疱疹液、粪便或肛拭子检出的阳性率较高,均在50.00%以上,而脑脊液、血液样本中未检出阳性。59份临床诊断病例粪便样本中分离出肠道病毒10株,其中EV71型病毒7株,CoxA16型病毒3株。结论手足口病在湖南省境内常年发生,5～7月是高发时期;病原体主要为EV71型肠道病毒,易导致重症病例甚至死亡病例;咽拭子、疱疹液、粪便/肛拭子是手足口病实验室诊断较敏感标本。【Objective】 To analyze epidemiologic features of hand-foot-mouth disease（HFMD） in Hunan province,and to understand the main type of the HFMD pathogen so as to provide scientific evidence for disease control and prevention.【Methods】 Descriptive epidemiological study was applied to analysis of epidemiologic features of HFMD.Herpes fluid,throat swab,anal swab,stool samples of clinically diagnosed HFMD cases were collected.Nucleic acids of three types of virus i.e.enter virus（EV）,enter virus 71（EV71） and Coxsackie virus A16（CoxA16）,were detected by RT-PCR method both in original samples and isolated positive virus strains.Virus was isolated by RD and Hep-2 cells from stool samples.【Results】 A total of 27 133 HFMD cases were reported in Hunan province in 2008,the annual incidence rate was 42.66/100 000.Although there were cases being reported in each month,the high period was from May to July.Cases were distributed in 121 counties（only one county had no case reported） in all over the province and were mainly sporadic.Sex ratio was 1.81∶1,and 89.43% of all reported cases were children cases aged5 years.Samples from 719 clinically diagnosed cases with HFMD were collected,306 cases（42.56%） were tested positive,including 239 cases of EV71 positive,and the EV positive rate of general cases（42.11%） was not statistic different from that（51.43%） of severe cases and dead cases（χ2=1.18,P =0.28）,but there was statistic difference between the EV 71 positive rate of general cases（32.31%） with that（51.43%） of severe cases and dead cases（χ2=5.48,P =0.02）.The EV positive rates of throat swab,Herpes fluid,anal swab,stool samples of clinically diagnosed cases with HFMD were high（all over 50%）.10 EV strains were isolated from 59 stool samples including 7 strains of EV71,3 strains of CoxA16.【Conclusion】 HFMD cases can appear all over Hunan province and in each month,but higher period is from May to July.The mainly kind of etiology that causes HFMD is EV71 in Hunan pr

关 键 词：手足口病 流行病学特征 肠道病毒(EV) 肠道病毒71型(EV71) COXA16 

分 类 号：R181.3[医药卫生—流行病学]