安康市2010—2012年手足口病重症病例流行病学分析

目的分析安康市2010—2012年重症手足口病流行病学特点，为进一步预防和控制手足口病提供科学依据。方法对2010—2012年安康市报告的所有重症手足口病病例进行个案调查和样品采集，用RT—PCR法对患者标本进行总肠道病毒、肠道病毒71型（EV71）和柯萨奇病毒A组16型（CoxA16）的特异性核酸检测。结果2010—2012年安康市共报告手足口病病例5998例，年均报告发病率为74．72／10万，其中重症病例52例，死亡1例。重症病例主要集中在4—7月和11～12月，年龄主要集中在3岁以下儿童（占78．85％），居住地为农村的40例（76．92％）；从发病到初次就诊平均时间0．54d，从发病到诊断为重症2．86d；初次就诊者32例未诊断出手足口病，村（个体）诊所和乡镇（社区）医院占81．26％；临床表现以发热和皮疹为主；实验室EV71检测率为42．31％，其他肠道病毒检测率为9．62％，CoxA16检测率为1．92％。结论加强基层培训、改善农村的环境卫生、加强疾病的监测、做好重症手足口病救治工作是防治重症手足口病的关键。

Analysis of epidemiology of severe hand - foot - mouth Disease in Ankang city during 2010 - 2012

Objective To explore the epidemiologic and etiological characteristics of severe hand - foot - mouth disease in Ankang from 2010 to 2012, by analyzing the characteristics of hand - foot - mouth disease epidem-ic. Methods To case investigation and collecting samples of severe hand -foot -mouth disease in Ankang 2010-2012, specific nucleic acid for Coxsackie virus A16 （CoxA16） and Enterovirus 71 （EV71） were de-tected by RT-PCR. Results Totally 5998 hand-foot- mouth disease cases have been reported in Ankang city from 2010 to 2012. The average rate of this period was 74.72 per 100000 one year. 52 cases of severe were reported and 1 died. The severe hand-foot-mouth disease was observed during April -July and No-vember-December. Main severe HFMD patients were children below 3 years, accounting for 78.85%. The 40 of severe hand - foot - mouth disease of family live in the countryside, The severe cases with a interval of 0.54 day between onset and medical care seeking accounted, the average interval between onset and diagnosis were 2.86 days. The first patient of severe cases were not diagnosed as hand - foot - mouth disease, individual clinic and health clinics in towns and townships for 81.26%. Clinical manifestations mainly fever and rash. In all severe HFMD, the detection rate of EV71 cases was 42.31%, other Enterovirus was 9.62%, the detection rate of CoxA16 was 1.92%. Conclusions Strengthen the grass - roots training, improving rural environmental sanitation, to strengthen the monitoring of disease, do a good job of severe hand - foot - mouth disease treat- ment, are the keys to the prevention of severe hand - foot - mouth disease.