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目的对江苏省无锡市2009年手足口病流行期间的手足口病患儿进行病原学及流行特征分析。方法对2009年398例手足口病普通病例及50例重症病例进行流行病学个案调查及采样,采集患儿的肛拭子、咽肛拭子标本进行核酸检测。结果无锡市2009年共报告手足口病8 416例,发病率为122.33/10万,发病年龄以<6岁儿童(96.49%)多见,其中1~3岁占61.76%,发病最高;重症病例≤2岁占60.00%;发病高峰为4-6月及11-12月;398例普通病例临床主要表现为手足臀及口腔疱疹,30.60%伴发热,98.50%有手足皮疹,81.90%有口腔溃疡或疱疹;重症病例均发热,就诊前平均体温38.95℃,平均发热3.75 d,均有皮疹,80.00%出现神经系统症状;病原学监测发现全年病原构成以EV71(62.11%)及CoxA16(37.89%)为主,重症病例EV71占88.00%;聚集性病例中由EV71引起感染占42.19%,Cox A16引起感染占51.56%,EV71/Cox A16混合感染占6.25%。结论 2009年无锡市手足口病流行存在2个高峰,病原构成仍以EV71和CoxA16感染为主,2种病毒引起的临床特征表现无明显差异,EV71感染更易表现为重症。
Objective To analyze the etiological and epidemiological characteristics of hand, foot and mouth disease during the 2009 HFMD in Wuxi, Jiangsu Province. Methods 398 cases of hand, foot and mouth disease in 2009 and 50 cases of severe cases of epidemiological case investigation and sampling, collection of children with anal swab, pharyngeal anal swab specimens for nucleic acid detection. Results A total of 8 416 hand-foot-mouth disease cases were reported in Wuxi in 2009, with an incidence rate of 122.33 / 100 000. The age of onset was more common in children <6 years old (96.49%), with 61.76% of them aged 1 to 3 years old, with the highest incidence. In severe cases ≤ 2 years old accounted for 60.00%; peak incidence of 4 - 6 months and 11-12 months; 398 cases of common clinical manifestations of hand, foot and buttocks and oral herpes, 30.60% with fever, 98.50% had hand-foot rash, 81.90% had oral ulcers Or herpes. In severe cases, the average temperature was 38.95 ℃ and the average fever was 3.75 days. There were rashes and 80.00% neurological symptoms. The etiological surveillance showed that the etiological agents were EV71 (62.11%) and CoxA16 (37.89% ), 88.00% for severe case EV71, 42.19% for EV71, 61.56% for Cox A16 and 6.25% for EV71 / Cox A16. Conclusion There were two peaks of HFMD in Wuxi in 2009. The pathogens were still predominantly EV71 and CoxA16. There was no significant difference in the clinical features of the two viruses. EV71 infection was more likely to be severe.