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目的了解2009~2013年宁德市手足口病的病原学特征及变化趋势,为手足口病防治工作提供科学依据。方法对宁德市11个手足口病哨点医院送检的手足口病病例咽拭子,应用实时荧光定量反转录-聚合酶链反应(Real-time PCR,RT-PCR)技术进行检测并判定病毒型别。结果 2009~2013年宁德市11个哨点医院共送检手足口病病例标本1 772份,检出阳性1 056例,阳性率59.59%,其中,单一肠道病毒71型(EV71)433例(41.00%),单一柯萨奇病毒A组16型(CVA16)238例(22.54%),EV71/CVA16混合感染4例(0.38%),其他肠道病毒阳性381例(36.08%);2009~2013年EV71型肠道病毒构成比分别为83.91%、75.14%、50.44%、36.19%、10.60%,呈逐年递减;而其他肠道病毒构成比分别为2.30%、1.10%、3.54%、41.55%、72.19%,呈逐年递增,在2012、2013年呈显著增加;EV71为重症和死亡病例的主要型别(85.71%);死亡7例均为EV71型感染。结论 2009~2011年宁德市手足口病病原体以EV71为主,2012和2013年其他肠道病毒已成为引起宁德市手足口病最主要的病原体;EV71仍然是引起手足口病重症和死亡病例的优势流行型别。
Objective To understand the etiological characteristics and trends of HFMD in Ningde from 2009 to 2013 and provide a scientific basis for the prevention and treatment of HFMD. Methods Throat swabs were collected from 11 hand, foot and mouth disease sentinel hospitals in Ningde City for detection by real-time PCR (RT-PCR) Virus type. Results A total of 1 772 samples of hand-foot-mouth disease were sent out from 11 sentinel hospitals in Ningde from 2009 to 2013. The positive rate was 59.59%. Among them, 433 cases of single enterovirus 71 (EV71) 41.00%), 238 cases (22.54%) of single coxsackievirus A group 16 (CVA16), 4 cases (0.38%) of EV71 / CVA16 mixed infection and 381 cases (36.08%) of other enterovirus positive; The proportions of other enteroviruses were 83.91%, 75.14%, 50.44%, 36.19% and 10.60%, respectively. The proportions of other enteroviruses were 2.30%, 1.10%, 3.54% and 41.55% 72.19%, showing an increasing year by year, showing a significant increase in 2012 and 2013. EV71 was the major type of severe and fatal cases (85.71%), and all 7 died of EV71 infection. Conclusion The main pathogens of HFMD in Ningde from 2009 to 2011 are EV71, and other enteroviruses have become the major pathogens causing HFMD in Ningde City in 2012 and 2013. EV71 is still the predominant cause of HFMD and death Popular type.