一起柯萨奇病毒A6型引起的幼儿园手足口病和疱疹性咽颊炎聚集性疫情分析

钱燕琴 马纪林 许成美 雷良文

摘 要 目的：通过收集和整理上海松江区泗泾镇某幼儿院1起手足口病混合疱疹性咽峡炎聚集性疫情的相关数据，分析其流行病学特征，为制定手足口病和疱疹性咽峡炎防控提供依据。方法：采用现场流行病学对病例进行回顾性研究，运用描述流行病学方法对聚集性疫情进行分析，采集病例粪便样品进行肠道病毒71（enterovirus 71，EV71）、柯萨奇病毒A16（Coxsackievirus A16，CoxA16）、柯萨奇病毒A6（Coxsackievirus A6，CoxA6）以及肠道病毒通用型检测。结果：共报告20例病例，采集5例病例的粪便样本检测均为CoxA6阳性。结论：本起疫情为肠道病毒CoxA6型引起的手足口病混合疱疹性咽峡炎聚集性疫情，原因可能是首例病例发病后未及时发现和未及时做好病例隔离和消毒处置。

关键词 手足口病；疱疹性咽峡炎；聚集性疫情；柯萨奇病毒A6

中图分类号：R183.3 文献标志码：A 文章编号：1006-1533（2021）18-0056-04

Analysis of a clustered epidemic situation of hand， foot and mouth disease and herpangina in the kindergarten caused by Coxsackievirus A6

QIAN Yanqin， MA Jilin， XU Chengmei， LEI Liangwen

（Prevention and Health Care Department of Sijing Community Health Service Center of Songjiang District， Shanghai 201601， China）

ABSTRACT Objective： Through collecting and sorting out the relevant data of an epidemic situation of hand， foot and mouth disease mixed herpangina a in a kindergarten in Sijing Community， Songjiang District， Shanghai， to analyze the epidemiological characteristics， and to provide basis for the prevention and control of hand， foot and mouth disease and herpangina. Methods： The cases were studied retrospectively by field epidemiology， and the aggregated epidemic situation was analyzed by descriptive epidemiology. Stool samples of the cases were collected for enterovirus 71（EV71）， Coxsackievirus A16（CoxA16）， Coxsackievirus A6（CoxA6） and enterovirus universal detection. Results： A total of 20 cases were reported， stool samples from 5 cases were positive for CoxA6. Conclusion： This epidemic is an aggregated epidemic of hand， foot and mouth disease and herpangina caused by CoxA6， and the reason may be that the first case is not found in time， and the isolation and disinfection of the case are not well done.

KEY WORDS hand foot and mouth disease； herpangina； cluster epidemic situation； Coxsackievirus A6

手足口病主要是以肠道病毒71（enterovirus 71，EV71）和柯萨奇病毒A16（Coxsackievirus A16，CoxA16）引起的常见传染病，多发于5周岁以下婴幼儿[1]。近年来，非EV 71和非Cox A16肠道病毒引起手足口病疫情也较为频繁，其中最常见的是柯萨奇病毒A6型（Coxsackievirus A6，CoxA6）[2]。疱疹性咽颊炎也是主要由肠道病毒感染引起，与柯萨奇病毒A组1～6型、 8型、10型和22型关系较为密切[3]。与手足口病症状最大的区别是疱疹性咽颊炎的疱疹仅限于口腔，手和足不出疹，两种疾病均以粪-口途径传播为主[4-5]。本文旨在分析一起幼兒园手足口病与疱疹性咽峡炎并发聚集性疫情的发病趋势和流行特征，为社区的疫情防控提供依据。

1 资料与方法

1.1 资料