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目的探讨云浮市手足口病的流行病学及病原学特征,为防控手足口病提供科学依据。方法对2009-2015年云浮市报告的手足口病流行病学特征进行分析,结合重症病例个案流行病学调查,采用RT-PCR-荧光探针法检测患者粪便或肛拭子标本的肠道病毒类型(EV71、CA16和其他肠道病毒)。结果 2009-2015年云浮市共报告手足口病59 945例,年均发病率356.54/10万,居法定传染病首位,其中重症66例,死亡8例,发病呈夏季高峰和秋季次高峰的双峰分布,5岁以下儿童占87.82%(52 644/59 945),男女性别比1.69∶1,散居儿童占90.64%(54 335/59 945)。重症发生率110.10/10万,发生在5-7月的夏季高峰的占69.70%(46/66),0~2岁组占84.85%(56/66),重症病例中散居儿童占88.88%(58/66),但幼托儿童发生率(288.08/10万)大于散居儿童(106.75/10万)。重症病例中EV71病毒占80.00%(32/40)。8例死亡病例有6例为EV71病毒感染。结论云浮市手足口病在全市广泛流行,是一种危害儿童健康的高发常见病。当前应建立手足口病病原学的哨点监测系统,重点在5-7月的重症高发季节关注2岁以下儿童,加强EV71病原学监测。
Objective To investigate the epidemiological and etiological characteristics of HFMD in Yunfu and provide a scientific basis for prevention and control of HFMD. Methods The epidemiological characteristics of hand-foot-mouth disease reported in Yunfu from 2009 to 2015 were analyzed. Combined with the case-based epidemiological investigation of severe cases, RT-PCR-fluorescence probe was used to detect enterovirus in fecal or anal swab specimens Type (EV71, CA16 and other enteroviruses). Results A total of 59 945 HFMD cases were reported in Yunfu City from 2009 to 2015, with an average annual incidence of 356.54 / 100 000, ranking first in legal infectious diseases, including 66 severe cases and 8 deaths. The incidence peaked at summer and autumn The distribution of the peak was 87.82% (52 644/59 945) for children under 5 years of age, with a sex ratio of 1.69:1 for males and females and 90.64% for scattered children (54 335/59 945). The incidence of severe diseases was 110.10 / 100 000, accounting for 69.70% (46/66) in summer peak from May to July, 84.85% (56/66) in 0-2 years and 88.88% in critically ill patients 58/66). However, the incidence of child care child care (288.08 / 100,000) was higher than that of scattered children (106.75 / 100,000). EV71 virus accounts for 80.00% (32/40) in severe cases. Six of the eight deaths were EV71 virus infections. Conclusion Hand-foot-mouth disease in Yunfu City is widely prevalent in the city and is a common disease with high risk to children’s health. At present, a sentinel monitoring system for the pathogenesis of hand, foot and mouth disease should be established. The focus should be on monitoring the EV71 etiology in children under 2 years old in the critical stage of severe illness in May-July.