手足口病(Hand,foot and mouth disease,HFMD)是一种全球性的病毒性传染病,目前已成为重要的公共卫生问题,引起世界各国的广泛关注。自20世纪90年代开始,该病在亚太地区频繁暴发,中国自2008年出现全国范围的HFMD大暴发,重症和死亡病例...手足口病(Hand,foot and mouth disease,HFMD)是一种全球性的病毒性传染病,目前已成为重要的公共卫生问题,引起世界各国的广泛关注。自20世纪90年代开始,该病在亚太地区频繁暴发,中国自2008年出现全国范围的HFMD大暴发,重症和死亡病例居高不下。虽然多年来中国大陆HFMD主要病原多为肠道病毒A组71型(Enterovirus A71,EV-A71)和柯萨奇病毒A组16型(Coxsackievirus A16,CVA16),但病原谱在不断变化,病原在逐步进化,情况日趋复杂。本文就中国HFMD的流行状况、病原谱变化进行综述和初步分析。展开更多
Hand foot and mouth disease is a febrile sickness complex characterized by cutaneous eruption (exanthem) on the palms and soles with simultaneous occurrence of muco-cutanous vesiculo-ulcerative lesions (enanthem) affe...Hand foot and mouth disease is a febrile sickness complex characterized by cutaneous eruption (exanthem) on the palms and soles with simultaneous occurrence of muco-cutanous vesiculo-ulcerative lesions (enanthem) affecting the mouth. The illness is caused by a number of enteroviruses with coxsackievirus A16 and enterovirus 71 as the main causative agents. Human enterovirus 71 (EV71) belongs to the species Human enterovirus A under the genus Enterovirus within the family Picornaviridae. EV71 has been associated with an array of clinical diseases including hand foot and mouth disease (HFMD), aseptic meningitis, encephalitis and poliomyelitis-like acute flaccid paralysis. A large outbreak of HFMD due to highly neurovirulent EV71 emerged in Malaysia in 1997, and caused 41 deaths amongst young children. In late 2000, a recurrence of an outbreak of HFMD occurred in Malaysia with 8 fatalities in peninsular Malaysia. Outbreak of HFMD due to EV71 recurred in 2003 with an unknown number of cases and mortalities. A similar outbreak of HFMD with 2 recorded deaths in young children occurred in peninsular Malaysia in late 2005 and this was followed by a larger outbreak in Sarawak (Malaysian Borneo) with 6 reported fatalities in the early part of 2006. The current on-going outbreak of HFMD started in peninsular Malaysia in epidemiological week 12 of 2010. As with other HFMD outbreaks in Malaysia, both EV71 and CA16 were the main aetiological viruses isolated. In similarity with the HFMD outbreak in 2005, the isolation of CA16 preceded the appearance of EV71. Based on the VP1 gene nucleotide sequences, 4 sub-genogroups of EV71 (C1, C2, B3 and B4) co-circulated and caused the outbreak of hand, foot and mouth disease in peninsular Malaysia in 1997. Two sub-genogroups (C1 and B4) were noted to cause the outbreak in 2000 in both peninsular Malaysia and Sarawak. EV71 of sub-genogroup B5 with smaller contribution from sub-genogroup C1 caused the outbreak in 2003. In the 2005 outbreak, besides the EV71 strains of sub-genogroup C1, EV71展开更多
手足口病（Hand-foot and mouth diseas，HFMD）是婴幼儿及学龄前期儿童常见的疾病，属隐性感染性传染病，常呈爆发性流行。引起本病的肠道病毒达20余种，以柯萨奇病毒A10和肠病毒71型最常见。本病患者、隐性感染者和无症状带毒者主要...手足口病（Hand-foot and mouth diseas，HFMD）是婴幼儿及学龄前期儿童常见的疾病，属隐性感染性传染病，常呈爆发性流行。引起本病的肠道病毒达20余种，以柯萨奇病毒A10和肠病毒71型最常见。本病患者、隐性感染者和无症状带毒者主要是通过密切接触含有病毒的污染物，经消化道传播，另外由于吸入空气、飞沫中的病毒，经呼吸道传播，多在婴幼儿群体中流行，目前尚无特效治疗方法，主要以对症治疗和护理为主。该病多数预后良好，多数可自然痊愈，但可出现并发症，有文献报道HFMD流行时伴随较高的死亡率，亦有文献报道该病可引起心脏损害巩精心细致的护理在该病中起着重要作用。2005年我市发生本病流行，现将病史资料完整的68例患儿的护理情况分析报告如下。展开更多
文摘Hand foot and mouth disease is a febrile sickness complex characterized by cutaneous eruption (exanthem) on the palms and soles with simultaneous occurrence of muco-cutanous vesiculo-ulcerative lesions (enanthem) affecting the mouth. The illness is caused by a number of enteroviruses with coxsackievirus A16 and enterovirus 71 as the main causative agents. Human enterovirus 71 (EV71) belongs to the species Human enterovirus A under the genus Enterovirus within the family Picornaviridae. EV71 has been associated with an array of clinical diseases including hand foot and mouth disease (HFMD), aseptic meningitis, encephalitis and poliomyelitis-like acute flaccid paralysis. A large outbreak of HFMD due to highly neurovirulent EV71 emerged in Malaysia in 1997, and caused 41 deaths amongst young children. In late 2000, a recurrence of an outbreak of HFMD occurred in Malaysia with 8 fatalities in peninsular Malaysia. Outbreak of HFMD due to EV71 recurred in 2003 with an unknown number of cases and mortalities. A similar outbreak of HFMD with 2 recorded deaths in young children occurred in peninsular Malaysia in late 2005 and this was followed by a larger outbreak in Sarawak (Malaysian Borneo) with 6 reported fatalities in the early part of 2006. The current on-going outbreak of HFMD started in peninsular Malaysia in epidemiological week 12 of 2010. As with other HFMD outbreaks in Malaysia, both EV71 and CA16 were the main aetiological viruses isolated. In similarity with the HFMD outbreak in 2005, the isolation of CA16 preceded the appearance of EV71. Based on the VP1 gene nucleotide sequences, 4 sub-genogroups of EV71 (C1, C2, B3 and B4) co-circulated and caused the outbreak of hand, foot and mouth disease in peninsular Malaysia in 1997. Two sub-genogroups (C1 and B4) were noted to cause the outbreak in 2000 in both peninsular Malaysia and Sarawak. EV71 of sub-genogroup B5 with smaller contribution from sub-genogroup C1 caused the outbreak in 2003. In the 2005 outbreak, besides the EV71 strains of sub-genogroup C1, EV71
文摘手足口病（Hand-foot and mouth diseas，HFMD）是婴幼儿及学龄前期儿童常见的疾病，属隐性感染性传染病，常呈爆发性流行。引起本病的肠道病毒达20余种，以柯萨奇病毒A10和肠病毒71型最常见。本病患者、隐性感染者和无症状带毒者主要是通过密切接触含有病毒的污染物，经消化道传播，另外由于吸入空气、飞沫中的病毒，经呼吸道传播，多在婴幼儿群体中流行，目前尚无特效治疗方法，主要以对症治疗和护理为主。该病多数预后良好，多数可自然痊愈，但可出现并发症，有文献报道HFMD流行时伴随较高的死亡率，亦有文献报道该病可引起心脏损害巩精心细致的护理在该病中起着重要作用。2005年我市发生本病流行，现将病史资料完整的68例患儿的护理情况分析报告如下。
