广州市及周边地区2011年手足口病病原学与分子流行病学调查

Etiological and epidemiological study of hand-foot-and-mouth disease in Guangzhou and its surrounding area, 2011

目的对广州市及周边地区手足口病(HFMD)的流行病学和病原学特征进行分析。方法收集2011年广州市及其周边地区手足口病病例968份,采用荧光定量RT-PCR方法对采集的标本进行肠道病毒(EV)核酸检测,将其分为肠道病71型(EV71)、萨克奇病毒A组16型(CA16)、非EV71、CA16阳性肠道病毒(N)三类,分离部分EV71毒株并进行全基因测序和分析。并用生物信息学软件进行病毒基因特征分析,经在线比对后进行EV型别鉴定。结果分析显示2011年广州市及周边地区HFMD的高发年龄段为年龄小于4岁的儿童,1～2岁婴幼儿发病率最高;5-7月为发病高峰期;EV71和CA16为HFMD的主要病原;但有24.79%的病例由其他肠道病毒(EV)型别引起。基于全基因序列构建种系发生进化树显示,所分离的6株EV71毒株与C4亚型毒株具有最近的亲缘性和最高的同源性。结论2011年EV71和CA16为广州市及周边地区流行的主要病原,EV71病毒株分离株属于C4型,且遗传性较稳定,但存在部分其他型别EV引起HFMD。

Objective To study the etiological and epidemiological characteristic of hand-foot-and-mouth disease （HFMD） in Guangzhou and its surrounding area in 2011. Method HFMD inpatients cases in 2011 were collected, and the cases were studied by both epidemiological and laboratory analysis. Results According to the epidemiological study, children less than 4 years old were the most susceptible population group, and the group aged 1-2 year represented the highest number of the cases;the high incidence of the epidemic occurred from May to July. Laboratory studies indicated that EV71 and CA16 were the two major pathogens for the outbreak of HFMD in these areas, other types of EV were also responsible for 24.79% cases.Based on the phylogenic analysis of the sequences of whole genome, six EV71 isolates of Guangdong belonged to C4 subgenotype and showed the highest homology with it. Conclusions This study indicated that CA16 and EV7I were the major pathogen circulating in these areas; EV71 belonged to C4, and the genetic characteristic was stable. Other types of EV were also responsible for the HFMD cases.