一起EV71肠道病毒引起的社区手足口病暴发流行调查  

Investigation on a hand-foot-mouth disease outbreak caused by Enterovirus 71 in community

作　　者：刘渠[1] 曹桂华[1] 林琳[1] 张茂棠[1] 李刚[1] 张起文[1] 刘凤仁[1] 叶伟雄[1] 龙清平[1] 董建[1] 陈嘉慧[1] 叶碧莉[1] 庄辉元[1] 孙春云[1] 陈应坚[1] 甘莉萍[1] 徐亚军[1] 杨坤祥[1] 段小贝 邱泽文 廖瑞容 赖小生 张暹喜 陈显荣 邹崇杰 罗娘胡 蓝文聪 

机构地区：[1]广东省深圳市龙岗区疾病预防控制中心流行病科,518172 [2]深圳市龙岗区卫生局 [3]深圳市龙岗区坑梓街道预防保健所

出　　处：《职业与健康》2013年第5期595-598,共4页Occupation and Health

摘　　要：目的了解深圳市龙岗区手足口病暴发疫情的流行病学与病原学特征,为手足口病的预防控制策略提供科学依据。方法采用描述流行病学方法对龙岗区某社区手足口病暴发疫情的流行病学资料进行统计分析,采集手足口病患儿发病3日内、疫点周围健康人群及密切接触者、疫区3岁以下易感儿童的粪便、肛拭子或疱疹液标本以及外环境涂抹棉拭子标本,采取实时荧光定量反转录-聚合酶链反应(RT-PCR)方法进行EV71和CoxA16核酸检测。结果流行期6月30日—7月27日,持续28 d。发病以4岁以下儿童为主,占88.46%;男性多于女性,男女性别比1.36∶1;职业以散居儿童和托幼儿童为主,占73.08%和19.23%。病原学检测结果显示,手足口病患儿标本EV71病毒核酸阳性率为87.50%(7/8)。2名死亡病例及其中1名死亡病例的密切接触者均检出EV71病毒核酸阳性。疫点周围健康人群及密切接触者EV71病毒核酸阳性率为4.17%(1/24)。外环境标本EV71病毒核酸阳性率为零(0/25)。疫区3岁以下易感儿童EV71病毒核酸阳性率1.92%(12/262)。结论该起手足口病暴发疫情病原体为EV71病毒引起。手足口病暴发流行已经成为我国南方城市重要的公共卫生问题。[ Objective ] To understand the epidemiological and etiological characteristics of hand-foot-mouth disease （HFMD） out-break in Longgang District of Shenzhen City, provide a scientific basis for HFMD prevention and control measures. [ Methods ] The epidemiological data of HFMD outbreak in a community of Longgang District were analyzed with descriptive epidemiological method. The stool specimens, anus swabs or herpes fluid specimens, and external environment cotton swabs were collected from HFMD pa-tients within 3 days after the onset, healthy population near outbreak area, close contacts and susceptible children under 3 years old in outbreak area. Fluorescence quantitative RT-PCR was performed to detect nucleic acid of enterovirus 71 （ EVT1 ） and coxsack-ievirus A16 （ CoxA16）. [Results]The epidemic stage occurred from June 30 to July 27, lasting for 28 days. 88.46% of patients were children under 4 years old, and boys were more than girls with the male-to-female ratio of 1.36： 1. The scattered children and kindergarten children accounted for 73.08% and 19.23% respectively. The pathogenic detection showed that the positive rate of EV71 nucleic acid was 87.50% （7/81 , and the EV71 nucleic acid was found in 2 death cases and the close contacts of a death case. The positive rate of EV71 nucleic acid in healthy population near outbreak area and close contacts was 4.17% （ 1/24）, the positive rate of external environment samples was 0, and that among susceptible children under 3 years old in outbreak area was 1.92% （ 12/262）. [ Conclusion] This HFMD outbreak is caused by EV71. HFMD outbreak has become an important public prob-lem in south China.

关 键 词：手足口病 暴发疫情 流行病学调查 病原学 监测 

分 类 号：R181.3[医药卫生—流行病学]