2007～2012年山东省临沂市手足口病流行病学和肠道病毒71型基因特征分析  

Epidemiology of Hand,Foot,and Mouth Disease and Genetic Characterization of Enterovirus A71:A Survey from 2007 to 2012 in Linyi of Shandong Province,China

作　　者：张盛[1] 张勇[1] 檀晓娟[1] 林艺[2] 王连森[2] 祝双利[1] 李晓嫘[1] 王东艳[1] 徐爱强[2] 裴耀文[2] 王显军[2] 许文波[1] 

机构地区：[1]中国疾病预防控制中心病毒病预防控制所世界卫生组织西太平洋区脊髓灰质炎参比实验室,北京102206 [2]山东省疾病预防控制中心,济南250061

出　　处：《病毒学报》2014年第3期246-252,共7页Chinese Journal of Virology

基　　金：973(项目号2011CB504902);国家科技重大专项(项目号。2012ZX10004201-003;2013ZX10004202);山东省科学技术发展计划(项目号2009GG10002055);山东省自然科学基金(项目号:ZR2013HM052)

摘　　要：为了分析山东省临沂市2007～2012年手足口病（Hand, foot, and mouth disease, HFMD）的流行病学和肠道病毒71型（Enterovirus A71, EV-A71）的基因特征，采用描述流行病学方法，对国家传染病监测信息报告管理系统中的HFMD疫情资料进行统计分析；对2007～2012年山东省临沂市HFMD病例的EV-A71分离株的VP1编码区进行逆转录-聚合酶链反应，并对扩增产物进行核苷酸序列测定，使用MEGA 5.0软件分析VP1区基因变异特征以及基因亲缘关系。结果显示，2007～2012年山东临沂市每年均有HFMD报告，其中2009年发病例数和死亡病例数最多，分别为14697例和9例，报告发病率为140.28/10万，死亡率为0.086/10万。发病高峰主要发生在4～7月，5月份最高；其中散居儿童发病数占77.37%～92.00%。2007～2009年发病高峰在2.5岁，2010～2012年发病高峰在1.5岁。连续6年实验室确诊HFMD共计1365例，占总病例数比例为2.98%；其中EV-A71构成比为44.18%，柯萨奇病毒A组16型（Coxsackievirus A16, CVA16）为46.59%。2007～2012年在山东省临沂市分离到的EV-A71均属于C4基因亚型中C4a进化分支。2007～2012年山东省临沂市均有HFMD暴发流行，各区县发病率有明显差异，发病高峰在每年的4～7月。发病年龄集中在3岁以下儿童，散居儿童构成比例最高。各年份引起HFMD的病原体均以EV-A71和CVA16共循环为主。自2007年在山东省临沂市发现EV-A71 C4基因亚型的C4a引起的HFMD疫情以来，C4a在临沂市已经持续传播和流行了6年。To investigate the epidemiology of hand, foot, and mouth disease （HFMD） and the genetic characteristics of enterovirus A71 （EV-A71） in Linyi of Shandong Province, China during 2007-2012. The number of reported HFMD cases were obtained from the National Notifiable Disease Reporting System （NNDRS） were analyzed by descriptive epidemiology method; the VP1 region of EV-A71 isolated from HFMD patients in Linyi was amplified and sequenced. Finally, the genetic variability and phylogenecity of VP1 sequences of EV-A71 were analyzed by MEGA 5.0. The results showed that HFMD incidence was reported in each year from 2007 to 2012 in Linyi, and the highest incidence and mortality were reported in 2009, when there were total 14697 cases and 9 of death. The reported incidence was 140.28/100000, and the mortality was 0. 086/100000. The peak incidence usually occurred between April and July, and the summit occurred in May. Scattered children accounted for 77.37%-92.00% of all cases. The peak age was 2.5 years during 2007-2009 and 1.5 years during 2010-2012. A total of 1365 laboratory-confirmed HFMD cases were reported in the 6 consecutive years, accounting for 2.98% of the gross number. Among these reports, the ratio of EV-AT1 was 44.18%, and the ratio of coxsackievirus A16 （CVA16） was 46.59%. All EV-A71 strains isolated in Linyi during 2007-2012 belonged to the C4a evolutionary branch of C4 genotype. In conclusion, HFMD outbreaks occurred every year in Linyi during 2007-2012. Incidence varied significantly among different counties. The peak incidence in each year lasted from April to July. Most of the patients were children under 3 years of age, and scattered children took the highest proportion. Co-circulation of EV-AT1 and CVA16 was the major cause of HFMD in each year. Since the first report of HFMD prevalence caused by EV-A71 （C4a） in 2007, the virus has been prevalent continuously in Linyi for 6 years.

关 键 词：手足口病 流行病学 EV-A71基因特征 

分 类 号：R373.9[医药卫生—病原生物学]