摘要
目的：了解2013年杭州市手足口病（ HFMD）流行特征、不同HFMD病原体与疾病严重程度关系以及人肠道病毒71型（ HEV71）阳性重症HFMD患儿接触人群HEV71携带率。方法：采集2013年杭州市儿童医院收治的HFMD疑似患儿咽拭子或粪便标本，采用实时荧光定量PCR检测HFMD病原体，了解轻症和重症HFMD患儿中HFMD病原体的分布。选取54例HEV71阳性重症HFMD患儿家属中密切接触和一般接触者各1名，检测其粪便标本中的HEV71并随访1个月。分析杭州市儿童医院2011～2013年检出的HFMD病原体构成比差异和优势病原体转变。结果：849例HFMD疑似患儿中确诊641例，男女患儿比例1．4∶1，1～3岁患儿占80．3％。 HFMD患儿标本中24．3％（156/641）检出HEV71，4．7％（30/641）检出A组16型柯萨奇病毒（CVA16），71．0％（455/641）检出其他肠道病毒。75．6％（118/156）HEV71感染病例为重症HFMD，但CVA16和其他HFMD病毒感染病例中仅分别有13．3％（4/30）和6．2％（28/455）为重症HFMD，三者间差异有统计学意义（χ2＝43．28， P ＜0．05）。2011、2012年 HFMD 优势病原体为HEV71，2013年为其他肠道病毒。54例密切接触者和54例一般接触者中分别有9例和10例检出HEV71（ P＞0．05），且均无HFMD临床表现。结论：2013年杭州市HFMD流行季节、好发年龄与性别无明显变化，HEV71感染易引发重症HFMD，但其他肠道病毒已替代HEV71成为HFMD优势病原体。
Objective： To investigate the epidemic characteristics of hand-foot-and-mouth disease （ HFMD ） in children and exposed population in Hangzhou city . Methods： The throat swab or stool samples from children with HFMD admitted in Hangzhou Children′s Hospital were collected .The HFMD pathogens were detected by real-time fluorescent quantitative PCR .The distribution of different HFMD pathogens in HFMD patients was subsequently determined .Human enteric virus type-71 （ HEV71 ） in stool samples from subjects , who had close or general contact to 54 severe HFMD children with positive HEV 71 , was detected , and these contact persons were followed-up for one month .The diversity of predominant pathogens of HFMD in the area during 2011-2013 was investigated.Results： In 641 HFMD children, the male/female ratio was 1.4∶1 and 80.3% was 1-3 years old.HEV71 was detected in 24.3% HFMD children （ 156/641 ） , while coxakievirus group-A type-16 （ CVA16 ） and other enteroviruses were detected in 4.7%（30/641） and 71.0%（455/641） of the cases, respectively .75 .6% （ 118/156 ） of HEV71-infected cases were diagnosed as severe HFMD cases, while those for CVA16-infected and other HFMD viruses-infected were 13.3%（4/30） and 6.2%（28/455） respectively （χ2 =43.28, P〈0.05）.HEV71 was the predominant HFMD pathogens during 2011-2012 , while the predominant HFMD pathogens in 2013 were the other HFMD viruses .In the 54 close contact persons or 54 general contact persons , 9 or 10 persons were detectable for HEV 71 , but no clinical symptoms of HFMD were presented .Conclusion： There are no marked changes of epidemic seasons , favorable age and gender ratio of HFMD in Hangzhou area in 2013 . The infection of HEV71 tends to cause the severe HFMD but the other enteroviruses have substituted HEV 71 as the predominant pathogens of HFMD .
出处
《浙江大学学报（医学版）》
CAS
CSCD
北大核心
2014年第2期212-217,共6页
Journal of Zhejiang University(Medical Sciences)
基金
浙江省自然科学基金(LY13H040007)
浙江省医药卫生科技计划(2012KYB159)
杭州市卫生科技计划(2012B011)
关键词
手足口病
流行病学
手足口病
病因学
感染
浙江
流行病学
Hand,foot and mouth disease/epidemiology
Hand,foot and mouth disease/etiology
Infection
ZHEJIANG/epidemiology
