甘肃省2013～2016年手足口病病原学监测分析  

Surveillance Results of HFMD Pathogensinin Gansu Province,China,2013～2016

作　　者：陈建华[1] 张勇[2] 武海卓 于德山[1] 

机构地区：[1]甘肃省疾病预防控制中心,兰州730000 [2]中国疾病预防控制中心病毒病预防控制所卫生部医学病毒和病毒病重点实验室,北京102206

出　　处：《病毒学报》2017年第4期505-511,共7页Chinese Journal of Virology

基　　金：国家"十二五"艾滋病和病毒性肝炎等重大传染病防治科技重大专项(项目号:2012ZX10004-208);题目:甘肃及周边省区传染病病原谱流行规律研究;甘肃省卫生行业科研管理项目(项目号:GWGL2014-75);题目:甘肃省手足口病病原变异变迁研究~~

摘　　要：本研究对甘肃省2013~2016年手足口病病原监测结果进行分析,以了解甘肃省这几年病原谱的构成,主要病原的流行特点,为进一步做好手足口病防控工作提供依据。2013~2016年,甘肃省监测网络实验室对7 171份标本进行了核酸检测,对其中3373份阳性标本开展了病毒分离培养,对得到的阳性分离株进行全长VP1区核苷酸序列测定及其分子特征分析。检测到核酸阳性标本4 314份,EV71为1 153份,占病原构成的27.73%,CVA16为1 452份,占33.66%,其他肠道病毒为1 709份,占39.62%。重症病例124例,阳性97例,其中EV71为23例,占病原构成的23.71%,CVA16为9例,占9.28%,其他肠道病毒为64例,占65.98%,EV71+CA16混合型为1例,占1.03%;死亡病例2例,均为EV71。2013年以其他肠道病毒为主要病原,占36.76%(347/944);2014年以CVA16为主,占52.83%(625/1 183);2015年和2016年均以其他肠道病毒为主,分别占57.04%(531/931)和48.25%(606/1 256)。分离到的病毒株除了EV71和CVA16,其他肠道病毒以CVA6、CVA10和CVA4为主。2013~2016年中,不同年份流行的病原不尽相同,不同地区流行的主要病原也存在地区差异。对流行的几种主要病原的VP1区分析结果表明:C4a基因亚型EV71在甘肃省仍然持续流行;CVA16的流行则是B1b基因亚型占据优势,B1a基因亚型逐渐消失;甘肃省流行的CVA6和CVA10与国内流行的毒株亲缘关系相近,且存在不同的传播链。We analyzed the Hand,foot and mouth disease（HFMD）pathogenic surveillance results in Gansu province during 2013~2016,in order to understand the epidemic characteristics of main pathogens in recent years,and provide evidence for HFMD prevention and control.Nucleic acids were detected in 7,171 samples,and 3,373 positive samples were cultured.We analyzed and characterized the nucleotide sequences of major capsid protein（VP1）in positive isolates.Of 4,314 positive samples,1,153 were enterovirus 71（EV71;26.73% of pathogens）,1,452 were coxsackievirus A16（CVA16;33.66%）and 1,709 were other enteroviruses（EVs;39.62%）.We observed 124 ＂severe＂cases and 97 positive cases（23cases of EV71[23.71%],9cases of CVA16[9.28%],64 EV cases[65.98%],1case of EV71＋CA16[1.03%]）.Two deaths were due to EV71.Other Evs were the main pathogens in 2013,and accounted for 36.76%（347/840）of cases.CVA16 was the main pathogen in 2014,accounting for 52.83%（625/1,183）.Other Evs were the main pathogens in 2015 and 2016,accounting for 57.04%（531/931）and 48.25%（606/1,256）,respectively.Apart from EV71 and CVA16,the other isolated viral strains were CVA6,CVA10 and CVA4.Over 4years,the main pathogen in each year was different,and different in different regions.VP1 analyses of the main pathogens showed that the C4 agenotype of EV71 was present in Gansu Province.With regard to CVA16,the B1 bgenotype was prevalent,and the B1 agenotype disappeared gradually.The prevalence of CVA6 and CVA10was similar to that of strains found in China in recent years,but had a different transmission chain.

关 键 词：手足口病(HFMD) 病原学监测 肠道病毒A组71型 柯萨奇病毒A组16型 柯萨奇病毒A组6型 柯萨奇病毒A组10型 进化分析 

分 类 号：R373.2[医药卫生—病原生物学]