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目的了解乡镇手足口病病原分布特征和流行情况,为疾病防控提供科学依据。方法采集2013年-2015年乡镇卫生院首次就诊临床诊断手足口病病例标本312份,应用实时荧光PCR方法检测手足口病肠道病毒通用型(EV)、肠道病毒71型(EV71)、柯萨奇病毒CVA16、CVA6、CVA10型。结果共采集标本312份,肠道病毒检出率为58.65%。2013年优势病原为CVA6,占57.89%;2014年优势病原为CVA16,占38.37%;2015年优势病原为CVA6,占32.20%。高发年龄为1岁~5岁;发病人群以托幼儿童和散居儿童为主,托幼儿童阳性率高于散居儿童,差异具有统计学意义(P<0.05)。结论 CVA6在2013年-2015年海盐县手足口病病原谱中占有优势,CVA10也有潜在威胁。建议手足口病常规监测中增加对CVA6和CVA10及其他未定型肠道病毒的监测,加大重点人群的监管力度,有效控制重症病例和聚集性病例的发生。
Objective To understand the distribution characteristics and prevalence of hand, foot and mouth disease in towns and villages and provide a scientific basis for disease prevention and control. Methods 312 cases of hand-foot-mouth disease diagnosed in the first visit of township hospitals were collected from 2013 to 2015. Real-time fluorescence PCR was used to detect EV, EV71, Saatchi virus CVA16, CVA6, CVA10 type. Results A total of 312 specimens were collected, the detection rate of enterovirus was 58.65%. In 2013, the predominant pathogen was CVA6, accounting for 57.89%. In 2014, the predominant pathogen was CVA16, accounting for 38.37%. In 2015, the dominant pathogen was CVA6, accounting for 32.20%. High incidence of 1-year-old to 5-year-old; the incidence of children to child care and diaspora-based children, child care-positive children than children, the difference was statistically significant (P <0.05). Conclusion CVA6 has the predominance in the pathogen spectrum of hand-foot-mouth disease in Haiyan from 2013 to 2015, and CVA10 also poses a potential threat. It is recommended to routinely monitor hand, foot and mouth disease to increase the CVA6 and CVA10 and other undetermined enterovirus surveillance, increase the supervision of key populations, effectively control the incidence of severe cases and aggregated cases.