2011年-2013年湖州市儿童手足口病病原学监测分析

Etiological surveillance of children with hand foot and mouth disease in Huzhou city during 2011-2013

目的分析湖州市儿童手足口病病原学构成情况,为制定有效的防控策略提供依据。方法收集2011年-2013年湖州市手足口病疑似患者的咽拭子、疱疹液等标本926份,采用荧光定量RT-PCR方法进行肠道病毒(EV)、肠道病毒71型(EV71)和柯萨奇病毒A组16型(COA16)核酸检测,并对部分EV71和COA16核酸阳性标本进行VP1区的序列测定和分析。结果 926份疑似感染者的咽拭子、疱疹液中肠道病毒阳性率为71.1%(658/926),其中肠道病毒71型阳性率为21.0%(194/926),柯萨奇病毒A组16型阳性率为16.2%(150/926),其他肠道病毒阳性率为33.9%(314/926)。VP1区的序列分析和系统进化结果表明湖州地区检出的EV71为C4a基因型,COA16为B1基因型。结论湖州市儿童手足口病2011年-2012年主要以EV71、COA16肠道病毒感染为主,2013年以其他肠道病毒感染为主,加强EV71、COA16肠道病毒的监测,同时要关注其他肠道病毒的型别,更好地预防和控制儿童手足口病。

Objective Analysis the etiology constitute of children with hand foot and mouth disease （HFMD） in Huzhou in or- der to provide the basis for the development of effective prevention and control strategies. Methods A total of 926 pharyngeal swab and herpes liquid samples were collected from cases of HFMD patients in Huzhou between 2011 -2013. And all were ex- amined ith fluorescence quantitative RT -PCR for enterovirus （EV） , enterovirus 71 （EV71） and Coxsackie A16 （COAl6）. Sequencing and analyses of VP1 encoding gene were performed on EV71 and CVA16 positive specimens. Results Among the 926 pharyngeal swab and herpes liquid samples, the total positive rate of enterovirus were 71.1% （658/926）. EV71, COA16 and other enterovirus accounted 21.0% （ 194/926）, 16.2% （ 150/926）, 33.9% （314/926）, respectively. Phylogenetic analysis of the VP1 region showed that the EV71 and COAl6 strains belonged to C4a and B1 subgenotype respectively. Conclusion Children with hand foot and mouth disease （HFMD） in Huzhou were mainly infected by EVT1 and COAl6 between 2011 and 2012, and mainly infected by other enterovirus in 2013. So in order to have better prevention and control of HFMD, we must concern about other enteroviruses while strengthening EV71 and COA16 surveillance.