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目的分析2010-2013年间梧州市手足口病的病原学监测结果,探讨病毒流行特征,为今后制定预防及控制防治策略提供依据。方法采用RT-PCR法对1 835例手足口病临床诊断病例的肛拭子样本进行核酸检测,用SPSS对数据进行统计分析。结果 1 835例手足口病病例的肛拭子样本中,EV71、Cox A16、其他类型的EV的总检出阳性率分别为28.55%、26.75%、45.83%;病毒优势流行株由2010年以EV71为优势毒株逐渐转变成2013年以其他类型的EV为优势毒株;普通与重症病例的检出阳性率的差异有统计学意义(χ2=491.54,P<0.001),不同病毒类型在普通与重症病例间的构成的差异有统计学意义(普通与重症病例间的构成比总体比较的χ2为26.34,普通与重症病例间其他类型的EV构成比较χ2为120.61,EV71为219.98,Cox A16为48.67,均为P<0.001);以5岁内婴幼儿的肠道病毒阳性检出为主(总肠道病毒检出率构成比为90.91%)。结论 EV71更易导致重症,但致死亡的风险与其他病毒相同;病毒的优势流行株改变是否与气候相关并影响发病值得进一步研究;5岁以下儿童,特别是3岁以下的儿童为防止手足口病进展为重症、死亡病例时需重点关注的人群。
Objective To analyze the etiological surveillance of hand-foot-mouth disease in Wuzhou during 2010-2013 and to explore the epidemiological characteristics of the virus so as to provide basis for future prevention and control strategies. Methods RT-PCR was used to detect the nucleic acid of 1 835 samples of anal swab in clinical diagnosis of hand-foot-mouth disease. The data were analyzed by SPSS. Results The total positive rates of EV71, Cox A16 and other types of EV in 2835 cases of hand, foot and mouth disease were 28.55%, 26.75% and 45.83%, respectively. The predominant strains were gradually transformed into other strains of EV with the dominant strains in 2013. The positive rates of common and severe cases were statistically different (χ2 = 491.54, P <0.001) There was significant difference between the constitutions of severe cases (χ2 = 26.34 between the general and severe cases), the composition of other types of EV between ordinary and severe cases was χ2 = 120.61, EV71 = 219.98, Cox A16 = 48.67 , All P <0.001). The majority of cases were positive for enterovirus in infants aged 5 years (the detection rate of total enterovirus was 90.91%). Conclusions EV71 is more likely to cause severe illness, but the risk of death is the same as that of other viruses. Whether the predominant epidemic strains of the virus are related to climate and affect their pathogenesis deserves further study. Children under 5 years old, especially those under 3 years of age, Advances in severe, death cases need to focus on the crowd.