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2008-2009 年泰国手足口病的临床和分子特征。

Clinical and molecular characterization of hand-foot-and-mouth disease in Thailand, 2008-2009.

机构信息

Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

出版信息

Jpn J Infect Dis. 2010 Jul;63(4):229-33.

Abstract

Hand-foot-and-mouth disease (HFMD) is caused by a group of enteroviruses, most commonly coxsackievirus A 16 (CA16) and enterovirus 71 (EV71). In general, the disease is mild and self-limited except in the case of EV71 infections, which may incur serious complications. This research focused on virus characterization of HFMD cases in Thailand from 2008-2009, related clinical findings and complications of specific enterovirus subtypes. Specimens (stool, vesicle fluid, throat swab/sputum) from 48 cases were collected during 2008-2009. Reverse transcriptase-polymerase chain reaction (PCR) followed by direct sequencing and phylogenetic analysis served to detect enterovirus and determine subtype. Enterovirus was found in 58.3% (28/48) of cases, specifically EV71 (n=23), CA16 (n=4), and CA10 (n=1). Two patients infected by EV71 had brainstem encephalitis (one death). Eight patients required hospital admission due to dehydration. Of these, 3 were PCR positive for EV71, 1 for CA16, and the reminder negative. This study demonstrated EV71 as the most prevalent present cause of HFMD in Thailand in 2008-2009. Potentially fatal complications of HFMD should be taken into consideration. Surveillance of epidemiology and monitoring of disease severity should be continued, and as a prevention measure, sanitation and hygiene should be improved.

摘要

手足口病(HFMD)由一组肠道病毒引起,最常见的是柯萨奇病毒 A16(CA16)和肠道病毒 71(EV71)。一般而言,除了 EV71 感染可能导致严重并发症外,该疾病病情较轻且具有自限性。本研究专注于 2008-2009 年泰国手足口病病例的病毒特征、相关临床发现以及特定肠道病毒亚型的并发症。在 2008-2009 年期间收集了 48 例病例的标本(粪便、水疱液、咽喉拭子/痰)。采用逆转录-聚合酶链反应(PCR)直接测序和系统发生分析来检测肠道病毒并确定亚型。在 58.3%(28/48)的病例中发现了肠道病毒,具体为 EV71(n=23)、CA16(n=4)和 CA10(n=1)。两名感染 EV71 的患者患有脑干脑炎(1 例死亡)。由于脱水,有 8 名患者需要住院治疗。其中,3 例为 EV71PCR 阳性,1 例为 CA16PCR 阳性,其余为阴性。本研究表明 2008-2009 年 EV71 是泰国手足口病的主要流行原因。应考虑手足口病的潜在致命并发症。应继续进行流行病学监测和疾病严重程度监测,并采取改善卫生和卫生条件等预防措施。

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