2015年贵州省手足口病死亡病例流行特征和肠道病毒71型VP1区基因特征  

Epidemiological Characteristics of Deaths from Hand,Foot and Mouth Disease,and Genetic Characteristics of the VP1 Region of Enterovirus A71 in Guizhou Province,2015

作　　者：李法锦[1] 王丹[1] 韦小瑜[1] 郭军[1] 李世军[1] 蒋维佳[1] 王欢[2] 唐光鹏[1] 王定明[1] LI Fa-jin WANG Dan WEI Xiao-yu et al(Guizhou Provincial for Disease Control and Prevention, Guiyang 550004, Guizhou, Chin)

机构地区：[1]贵州省疾病预防控制中心,贵州贵阳550004 [2]遵义医学院医学与生物学研究中心,贵州遵义563000

出　　处：《中国疫苗和免疫》2016年第6期611-615,共5页Chinese Journal of Vaccines and Immunization

基　　金："十二五"国家科技重大专项(2012ZX1004-212);贵州省疾病预防控制中心基金项目(2016-E1-3青);贵州省卫生计生委科学技术基金项目(gzwjkj2016-1-053);贵州省普通高等学校传染病与生物安全特色重点实验室开放基金项目(K-009);贵州省普通高等学校传染病与生物安全特色重点实验室项目(黔教合KY字[2015]331)

摘　　要：目的分析贵州省2015年手足口病（Hand,Foot and Mouth Disease,HFMD）死亡病例的流行特征及其肠道病毒71型（Enterovirus A71,EV-A71）基因特征。方法采用描述性方法对中国疾病监测信息报告管理系统中报告的2015年贵州省HFMD死亡病例进行流行病学分析;对HFMD死亡病例的EV-A71分离株的VP1编码区进行逆转录-聚合酶链反应（RT-PCR）,测定扩增产物的核苷酸序列,使用MEGA 6.0软件分析VP1区基因变异特征及基因亲缘关系。结果 2015年贵州省HFMD报告发病33 852例,发病率为94.37/10万,死亡14例,死亡率为0.04/10万。死亡病例高峰在4～6月份。六盘水市报告的死亡病例占全部死亡病例的57.14%。92.86%的死亡病例≤1岁,死亡病例均为散居儿童,男女性别比为1.33∶1。所有死亡病例PCR检测均EV-A71阳性,均有发热,50%出现出疹。从HFMD死亡病例分离到8株EV-A71病毒株,均属于C4a基因亚型。结论 2015年贵州省HFMD死亡病例以小年龄散居儿童为主,主要由EV-A71的C4a基因亚型引起。应重点对小年龄儿童家长开展健康教育,加强HFMD重症病例的救治,以减少HFMD死亡。Objective To determine the epidemiological characteristics of deaths from hand,foot and mouth disease（ HFMD） and the genetic characteristics of the VP1 region of enterovirus A71（ EV-A71）strains isolated from death cases in Guizhou,2015. Methods Data on HFMD deaths in Guizhou,2015 were reported through the Chinese Disease Surveillance Information Management System and analyzed by descriptive epidemiological methods. The VP1 regions of EV-A71 strains isolated from HFMD death cases were amplified and sequenced by reverse transcription-polymerase chain reaction（ RT-PCR）. Genetic variation of VP1 region of EV-A71 and phylogenetic trees were analyzed by the MEGA 6. 0 software.Results 33 852 HFMD cases were reported in Guizhou in 2015,for an incidence rate of 94. 37 per100 000 population; 14 cases died,for a mortality rate of 0. 04 per 100 000 population. HFMD deaths peaked from April to June. Deaths in Liupanshui city accounted for 57. 14% of reported deaths;92. 86% of deaths were among children ≤1 year old,and all deaths were among scattered children. The male to female ratio was 1. 33 ∶ 1. All death cases were EV-A71 positive by PCR; all had high fever and 50% had rash. Eight strains of EV-A71 were isolated from death cases and were identified as C4 a sub-genotype. Conclusions In Guizhou in 2015,most deaths from HFMD occurred among young scattered children and were caused by the C4 a sub-genotype of EV-A71. We recommend conducting health education among parents of young children,and strengthen treatment of severe HFMD cases to reduce deaths.

关 键 词：手足口病 死亡 流行特征 基因型 

分 类 号：R186[医药卫生—流行病学]