2014—2016年孝感地区手足口病流行病学及柯萨奇病毒A6和A5型基因特征  

Epidemiological characteristics of hand-foot-mouth disease and gene features of Coxsackievirus A6 and A5 in Xiaogan Area from 2014-2016

作　　者：丁穗 李从荣[1] 王远虹[2] 骆胜超[3] 喻珂 张平[3] DING Sui;LI Cong-rong;WANG Yuan-hong;LUO Sheng-chao;YU Ke;ZHANG Pin(Department of Clinical Laboratory of People＇s Hospital of Wuhan University, Wuhan Hubei,430060,China;Department of Laboratory, Wuhan Center for Disease Control and Prevention, Wuhan Hubei , 430060, China;Department of Laboratory, X iaogan Center for Disease Control and Prevention, Xiaogan Hubei, 432100, China)

机构地区：[1]武汉大学人民医院检验科,湖北武汉430060 [2]武汉市疾病预防控制中心检验科,湖北武汉430060 [3]孝感市疾病预防控制中心检验科,湖北孝感432100

出　　处：《职业与健康》2018年第8期1038-1042,共5页Occupation and Health

摘　　要：目的了解2014—2016年孝感地区手足口病流行特点及未知病毒基因特征。方法通过"传染病报告信息管理系统"下载3年内孝感市辖区内疫情资料进行相关流行病学分析。收集医疗机构采集手足口病临床诊断咽拭子样本共计2 548份,经肠道病毒71型(EV71)和柯萨奇病毒A16(CVA16)荧光定量聚合酶链式反应(PCR)检测后仍然不能确定型别的肠道通用型病毒阳性样本作为研究对象,参考美国NCBI基因库,设计特异性引物进行VP1区(395bp)序列扩增分析后进行双向测序。将成功测序的基因片段序列进行VP1区基因片段聚类分析。结果孝感地区临床疑似病例中,3年内手足口病发病患者0~5岁病例数分别占总疑似病例数的97.74%、97.23%和97.05%;≤5岁儿童中,3年内男女比例分别为1.77∶1、1.87∶1和1.60∶1。基于VP1区片段聚类分析,结果显示3年内本地区CVA6型和CVA5型病毒与中国地区参考序列明显聚为一类。结论 2014—2016年孝感地区手足口病EV17型为主要病原体,CVA16型次之。该次实验首次发现本地区CVA5型和CVA6型病原体。[Objective]To understand the epidemic characteristics of hand-foot-mouth disease（HFMD） in Xiaogan Area from2014-2016,analyze the gene features of unknown virus. [Methods] The epidemic data in Xiaogan Area in three years were collected from the infectious disease report information management system,and analyzed by the epidemiological method. 2548 throat swab samples of HFMD clinical diagnosis cases were collected from medical institutions. The positive samples of general enteric virus,which the type could not be determined by EV71 and CVA16 fluorescent quantitative PCR detection,were selected as the research subject. Referring to US NCBI gene bank,specific primer was designed to perform VP1 region（395bp） sequence amplification and bidirectional sequencing. The cluster analysis of VP1 region gene fragments was conducted on successfully sequenced genes. [Results] In clinically suspected cases in Xiaogan Area,the HFMD patients aged 0-5 years old in three years was respectively 97.74%,97.23% and 97.05% of the total suspected cases. In children ≤5 years old,the ratio of male-to-female in three years was respectively1.77∶1,1.87∶1 and 1.60∶1. Based on VP1 region fragment cluster analysis,the result showed that the CVA6 and CVA5 viruses in this area were obviously the same type with reference sequence in Chinese regions within three years. [Conclusion] From 2014-2016,EV17 is the predominant causative agent in Xiaogan Area,followed by CVA16. The CVA5 and CVA6 pathogens are firstly found in this area by the experiment.

关 键 词：手足口病 柯萨奇A6型病毒 柯萨奇A5型病毒 系统进化分析 

分 类 号：R446.7[医药卫生—诊断学]