摘要
目的通过对2017年4月PD区一例重症手足口病病例的现场流行病学调查和分析,发现感染来源,明确传播关系。方法对一例手足口病重症病例的发病过程、流行病学接触史及家居卫生环境等影响因素开展流行病学调查,并采集病例及其密切接触者的标本进行病原学检测和生物信息学分析。结果发病前7d,该重症病例无可疑外出史,但与同村一儿童有密切接触,该儿童就读班级因发生手足口病聚集性病例而停课,其本人未出现症状,对重症病例、该可疑接触者及其班级首发手足口病病例粪便标本进行人肠道病毒核酸检测,检测结果均为EV71阳性。测序分析发现该3例样品均属于EV71C4a分支,重症病例与其可疑接触者序列完全一致,可疑接触者与其班级首发病例高度同源。结论EV71感染手足口病病例排毒时间长,隐性感染比例高,应重视隐性感染者在疾病传播过程中的重要作用。此外,集体机构采取关班等措施后,病例/隐性感染者在停课期间可能存在向社区传播风险。
Objective To find out the source of the severe case of HFMD occurred in PD District at April 2017by conducting field epidemiology investigation.Methods An epidemiological investigation was conducted on the clinical features,hygiene and environment conditions,contacts with suspected cases or has been to epidemic sites of a severe case of hand-foot-mouth disease,also the samples of the severe case and suspected persons were collected for PCR test and gene sequencing.Results The source of the severe case was from a carrier who was under observation since two of her classmates were suffering with HFMD.The samples of the severe case,the carrier and the first mild case of her classmate were all detected EV71positive.Sequential analysis showed they all belonged to C4a genotype,what's more,the outcome of the severe case was exactly as same as the carrier,while in highly consistent with the carrier's classmate.Conclusion The carriers or asymptomatic cases of HFMD and the long excretion period of EVT1 take an important role in virulence circumstance.Whether the closure of class when cluster cases occurred might stop the epidemic should be re-evaluated.
作者
顾霍铮
王远萍
叶楚楚
刘丹1
徐红梅
刘丹2
朱渭萍
徐飚
GU Huozheng;WANG Yuanping;YE Chuchu;LIU Dan;XU Hongmei;LIU Dan;ZHU Weiping;XU Biao(Shanghai Pudong New Area Centre for Disease Control and Prevention Department of Acute Infectious Disease Control,Shanghai 200136,China;Pudong Institute of Preventive Medicine,Fudan University,Shanghai 200136,China;School of Public Health,Fudan University,Shanghai 200032,China)
出处
《中国热带医学》
CAS
2018年第12期1273-1275,共3页
China Tropical Medicine
关键词
重症手足口病
流行病学调查
隐性感染者
severe case of hand-foot-mouth disease
epidemiologicalinvestigation
carrier
