2013年大连市手足口病病原监测结果分析

Etiological surveillance of hand-foot-mouth disease in Dalian in 2013

目的通过对2013年大连市手足口病(HFMD)的病原进行鉴定,以了解其型别分布。方法采用realtime-PCR方法对754份标本进行肠道病毒(EV)通用引物和肠道病毒71型(EV71)、柯萨奇病毒A组16型(CVA16)、柯萨奇病毒A组6型(CVA6)型特异性引物检测,对EV通用引物检测结果为阳性,但EV71、CVA16和CVA6检测结果均为阴性的标本采用巢氏PCR进行肠道病毒VP1基因部分序列的扩增、测序和生物信息学分析以鉴定其型别。结果 2013年引起大连市HFMD的主要病原CVA6占44.30%(334/754)、CVA16占19.12%(114/754)、EV71占11.54%(87/754),另有少数病例由CVA2、4、5、8型,CVB2、4型,ECHO9型及EV的其他型别引起。结论 CVA6取代EV71和CVA16成为2013年大连市HFMD病原的主要流行型别,后续应加强对HFMD病原的监测,全面了解其型别分布及毒株变异情况以更有效地控制疾病流行。

Objective To learn the etiological characteristics and distribution of hand-foot-mouth disease（ HFMD）in Dalian in 2013 and provide evidence for the prevention and control of the disease. Methods A total of 754 clinical specimens were collected and identified by realtime-PCR first; For those specimens of EV positive while EV71,CVA16 and CVA6 negative,a reverse transcription-seminested polymerase chain reaction（ RT-snPCR） was performed to amplify the partial sequence of the VP1 gene for subsequent analysis to identify the serotype. Results The results indicated that CVA6（ 44. 30%,334 /754）,CVA16（ 19. 12%,114 /754） and EV71（ 11. 54%,87 /754） were the major pathogens of HFMD in Dalian in 2013. Sequence analysis showed that 7 serotypes were obtained including CVA2,CVA4,CVA5,CVA8,CVB2,CVB4 and ECHO9. Conclusion CVA6 had replaced EV71 and CVA16 to become a new major pathogen of HFMD in Dalian in 2013. We should strengthen the monitoring of the pathogens in order to effectively control the prevelance of HFMD upon understanding of the distribution of its serotype and strain variation.