手足口病防治中感染控制问题文档资料.pptxVIP

手足口病防治中感染控制问题文档资料第1页/共63页卫生厅2手足口病（Hand-foot-mouth disease, HFMD）手足口病是由肠道病毒（以柯萨奇A组16型（CoxA16），肠道病毒71型(EV71)多见）引起的急性传染病，多发生于学龄前儿童，尤以3岁以下年龄组发病率最高。主要症状表现为手、足、口腔等部位的斑丘疹、疱疹，少数重症病例可出现脑膜炎、脑炎、脑脊髓炎、肺水肿、循环障碍等，多由EV71感染引起，致死原因主要为重症脑干脑炎及神经源性肺水肿。病人和隐性感染者均为传染源，主要通过消化道、呼吸道和密切接触等途径传播。引起手足口病的肠道病毒包括肠道病毒71型（EV71）和A组柯萨奇病毒（CoxA）、埃可病毒（Echo）的某些血清型。EV71感染引起重症病例的比例较大。肠道病毒传染性强，易引起暴发或流行。 第2页/共63页卫生厅3病原学引起手足口病的主要为小RNA病毒科、肠道病毒属的柯萨奇病毒(Coxasckie virus) A组16、4、5、7、9、10 型， B组2、5、13 型；埃可病毒（ECHO viruses）和肠道病毒71型（EV71），其中以EV71及Cox Al6型最为常见。第3页/共63页卫生厅4?微小RNA病毒Enterovirus PolioCoxsackie A and BEchoOther enterovirusesDiseases of the human (and other) alimentary tract (e.g. polio virus)RhinovirusDisease of the nasopharyngeal region (e.g. common cold virus)CardiovirusMurine encephalomyocarditis, Theilers murine encephalomyelitis virusAphthovirusFoot and mouth disease in cloven footed animalsHepatovirusHuman hepatitis virus AOthersDrosophila C virus, equine rhinoviruses, cricket paralysis virus第4页/共63页卫生厅5分组和血清型Picornaviridae（小RNA病毒科）At least 71 serotypes, divided into 4 subgroupsPolioviruses （脊髓灰质炎病毒）Coxsackie viruses（柯萨奇病毒）Echoviruses（埃可病毒）New enteroviruses（新肠道病毒）more recently, new enteroviruses subtype have been allocated sequential numbers (68-71))第5页/共63页卫生厅6肠道病毒分型Viral meningitis, rash,ARD4 types(68-71)其他肠道病毒Viral meningitis, with orchitis32 types埃可病毒Viral meningitis, but no orchitistypes (B1-B6)柯萨奇病毒BViral meningitis plus, rash, ARD, myocarditis, orchitis23 types ( A1-A22, A24)柯萨奇病毒AAsymptomatic infection, viral meningitis, paraalytic disease, poliomyelitis3 types脊髓灰质炎病毒所致疾病Clinical Diseases血清型Serotypes病毒第6页/共63页卫生厅7Coxsackie viruses GroupsGroup A viruses (23 types) Group B viruses (6 types)Distinguished from other enteroviruses by their pathogenicity for suckling miceGroup based on the lesions in suckling mice.第7页/共63页卫生厅8相关疾病Paralytic DiseaseMeningitis Encephalitis Undifferentiated febrile illness Hand fo