2015-2016年深圳市龙华区手足口病病原谱分析

Pathogenic spectrum analysis of hand-foot-and-mouth disease in Longhua district, Shenzhen city, 2015-2016

目的分析深圳市龙华区2015-2016年手足口病(HFMD)病原谱,为辖区内HFMD预防和控制策略的制订提供参考。方法采用荧光定量RT-PCR方法对2015-2016年辖区内447例HFMD病例样本及2016年辖区内疫情监测的75例HFMD病例样本进行肠道病毒(EV)、肠道病毒71型(EV-A71)和柯萨奇病毒A16型(CV-A16)核酸检测,并对非EV-A71非CV-A16的其他肠道病毒进行VP1区序列测定、亚型鉴定及进化分析。结果 2015-2016年辖区内447例HFMD病例样本实验室检测阳性率为81.21%(363/447),主要优势病原体为EV-A71、CV-A16和柯萨奇病毒A6型(CV-A6),总构成比为82.92%(301/363);2016年辖区内75例HFMD病例样本实验室检测阳性率为52.00%(39/75);EV-A71检出高峰集中在4-6月份,CV-A16的检出高峰集中在4-8月份,CV-A6检出集中在9-10月份;2015-2016辖区内HFMD中CV-A6呈多支分布。结论深圳市龙华区应进一步加强HFMD的病原谱监测及遗传分析,为进一步完善HFMD防控策略提供科学数据。

Objective Though the analysis of the pathogenic spectrum of hand-foot-and-mouth disease （HFMD） in Longhua district of Shenzhen city from 2015 to 2016 to provide important scientific evidence for the development of HFMD prevention and control strategies. Methods Fluorescence quantitative RT-PCR method was used to detect the nucleic acid of enterovirus （EV） , enterovirus 71 （EV-A71） and eoxsackievirus A16 （CV-A16） in 447 cases of HMDF in Longhua district. And the VP1 region sequences of neither non EV-A71 nor non CV-A16 were used for subtype identification and evolution analysis. Results The positive laboratory detection rate was 81.21% （363/447） in 447 HFMD samples from 2015 to 2016 and the main pathogens were EV-A71, CV-A16 and CV-A6, with a total composition ratio of 82.92%（301/363）. The positive laboratory detection rate was 52.00% （39/75） in 75 HFMD epidemic monitoring samples from 2016. The detection peak of EV-A71 was concentrated in April to June, while CV-A16 concentrated in April to August and CV-A6 in September to October. The CV-A6 distributed in multiple branches in the district from 2015 to 2016. Conclusion The pathogenic spectrum monitoring and genetic analysis of HFMD should be further strengthened in Longhua district, Shenzhen city to provide scientific data to support the improvement of HFMD prevention and control strategies.