2015~2018年柯萨奇病毒A组6型在黑龙江省的持续流行  

Continued Prevalence of Coxsackievirus A6 in Heilongjiang Province,China,from 2015 to 2018

作　　者：张曼[1,3] 陈淑红 张勇[3,4] 宋洋[3] 许军[2] 孙巍[2] 杨明[2] 韩振志[3] 肖金波[3] 路环环 许文波 刘志军 杨倩[3] ZHANG Man;CHEN Shuhong;ZHANG Yong;SONG Yang;XU Jun;SUN Wei;YANG Ming;HAN Zhenzhi;XIAO Jinbo;LU Huanhuan;XU Wenbo;LIU Zhijun;YANG Qian(Weifang Medical University,Weifang 261053,China;Heilongjiang Center for Disease Control and Prevention,Harbin 150001,China;National Polio Laboratory,WHO WPRO Regional Polio Reference Laboratory National Health Commission Key Laboratory for Medical Virology,National Institute for Biosecurity,National Institute for Viral Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Center for Biosafety Mega-Science,Chinese Academy of Sciences,Beijing 102206,China)

机构地区：[1]潍坊医学院,潍坊261053 [2]黑龙江省疾病预防控制中心,哈尔滨150001 [3]国家脊髓灰质炎实验室,世界卫生组织西太平洋区脊髓灰质炎参比实验室,国家卫生健康委员会生物安全重点实验室,国家卫生健康委员会医学病毒和病毒病重点实验室,中国疾病预防控制中心病毒病预防控制所,北京102206 [4]中国科学院生物安全大科学研究中心,北京102206

出　　处：《病毒学报》2020年第2期201-206,共6页Chinese Journal of Virology

基　　金：艾滋病、肝炎等传染病防治“十三五”科技重大专项(项目号:2018ZX10711001),题目:病毒感染高通量快速检测与应急筛检技术研究;艾滋病、肝炎等传染病防治“十三五”科技重大专项(项目号:2017ZX10104001),题目:基于全基因组的病毒网络化监测和溯源技术体系研究;十三五重大专项(项目号:2018ZX10305409-004-002),题目:宏基因组学快速感染诊断产品和传染病原分类方法开发;艾滋病、肝炎等传染病防治“十三五”国家科技重大专项(项目号:2018ZX10713002),题目:病毒性传染病病原谱和病毒基因变异变迁规律研究;黑龙江卫生计生委科研课题(项目号:2018561),题目:黑龙江省手足口病流行特征以及病原特性研究。

摘　　要：手足口病(Hand,foot,and mouth disease,HFMD)是一类常见的儿童传染病,自2009年以来,柯萨奇病毒A组6型(Coxsackievirus A6,CV-A6)已经成为引起HFMD流行持续循环的重要病原之一,是其他肠道病毒(Enterovirus,EV)中的优势病原,而黑龙江省CV-A6相关研究报道尚欠缺。本研究为了解2015~2018年黑龙江省HFMD流行概况和病原学组成,并分析该地区CV-A6的基因特征,收集2015~2018年黑龙江省HFMD疫情资料进行流行病学分析,并采集HFMD病例临床标本进行EV核酸检测。对分离出的EV毒株进行CV-A6的特异性荧光定量PCR法检测,对所有CV-A6阳性毒株进行全长VP1区扩增和核苷酸序列测定,并与GenBank上下载的CV-A6分型代表株构建系统进化树,以了解CV-A6的基因特征。流行病学结果显示,2015~2018年黑龙江省HFMD疫情平稳且2017年有所下降,无死亡病例。黑龙江省每年7月~8月为HFMD流行高峰,患病人群平均年龄为(4.39±3.74)岁,男女患病比例为1.44∶1。全省13个地市均收集到标本,哈尔滨市标本数最多,占36.77%。2015~2018年在黑龙江省共分离到69株CV-A6,与CV-A6原型株的核苷酸相似性为81.8%~83.9%,氨基酸相似性为94.0%~96.3%,均属D3基因亚型的D3a进化分支。尽管肠道病毒A组71型(Enterovirus A71,EV-A71)和CV-A16为主要病原,但D3基因亚型的CV-A6也已成为引起黑龙江省HFMD流行的稳定型别之一,且有加强的趋势,因此应加强CV-A6疫情的监控和分析,为该地区HFMD防控及疫苗研制提供基础数据。Hand,foot,and mouth disease(HFMD) is a common childhood infectious disease. Since 2009,coxsackievirus A6(CV-A6) has become one of the important pathogens causing continuous circulation of HFMD epidemics,and the dominant pathogen in other enterovirus(EV). CV-A6 related research reports are still lacking in Heilongjiang province,China. In order to understand the prevalence and etiology of HFMD in Heilongjiang Province,China from 2015 to 2018,and analyze the CV-A6 characteristics,HFMD epidemic data of Heilongjiang Province,China from 2015 to 2018 were collected for the epidemiological analysis,and clinical specimens from HFMD cases were collected for EV nucleic acid detection. The isolated EV strains were detected by real-time PCR for CV-A6. All CV-A6 positive strains were subjected to full-length VP1 region amplification and nucleotide sequence determination and sequence similarity analysis. Phylogenetic trees were constructed with representative CV-A6 typing strains downloaded from GenBank. Epidemiological results showed that the HFMD epidemic in Heilongjiang Province,China was stable from 2015 to 2018 and declined in2017,no deaths was found. In Heilongjiang Province,China,there was an HFMD epidemic peak from July to August each year. The average age of affected population is 4.39(± 3.74)years,and the proportion of male to female is 1.44∶1. Specimens were collected from 13 cities in the province,and the number of specimens in Harbin accounted for 36.77%. From 2015 to 2018,69 CV-A6 strains were isolated in Heilongjiang Province,China. The nucleotide similarity to the CV-A6 prototype was 81.8%-83.9%,and the amino acid similarity was94.0%-96.3%. All of the 69 strains belong to the D3 subtype D3 a evolutionary branch. Although EV-A71 and CV-A16 are main pathogens,CV-A6 of D3 has become one of the stable types causing HFMD epidemic in Heilongjiang Province,China,and there is a tendency to strengthen. Therefore,the surveillance and analysis of the CV-A6 epidemic situation should be strengthened in Heilongjiang Provin

关 键 词：柯萨奇病毒A组6型(CV-A6) D3基因亚型 手足口病(HFMD) 

分 类 号：R373.2[医药卫生—病原生物学]