论文部分内容阅读
目的分析引起海南省2010~2011年手足口病(Hand-Foot-Mouth Disease,HFMD)暴发流行的主要病原及其变化趋势,为海南省手足口病病例诊断和制定防控措施提供病原学依据。方法依据卫生部发布的《手足口病预防控制指南》进行手足口病例样本的处理和实验室检测。采用实时荧光-聚合酶链式反应(Real-time PCR)进行肠道病毒通用引物、肠道病毒71型(EV71)和柯萨奇病毒A16型(CoxA16)的核酸检测,核酸检测阳性的原始样本接种人横纹肌肉瘤细胞(Human Rhabdomyosarcoma,RD细胞)进行肠道病毒分离培养,选取有代表性的毒株进行病毒基因序列分析。结果 2010年和2011年海南省手足口重症病例中EV71感染率分别为45.52%和19.45%,而CoxA16的感染率仅为6.9%和4.7%;普通病例中的CoxA16感染率分别达到19.63%和24.8%,EV71的感染率分别为16.34%和6.36%。海南省2010年和2011年流行的EV71基因型均为C4a亚型,CoxA16病毒的基因型包括B1a和B1b,CoxA10、CoxA6和CoxA4也扮演着重要的角色,同时存在CoxA5、CoxB1、CoxB2、ECHO 3和ECHO 11等感染病例。引起海南省手足口重症病例的病原以EV71为主,也有少数病例为CoxA16的感染引起,2010年和2011年重症病例中CoxA16的感染率分别为6.9%和4.7%;而且CoxA10和CoxA6感染引起的重症病例比例较之CoxA4感染引起的重症病例的比例更高。结论海南省2010~2011年手足口重症病例仍以EV71感染为主,普通病例中EV71感染率逐渐下降,CoxA16感染率上升。在海南省人群中同时存在多种肠道病毒病原,导致海南省手足口病疫情的高发和重症病例的持续出现,尤其是CoxA10和CoxA6感染易导致重症病例的发生,值得进一步开展相关研究工作。
Objective To analyze the major pathogens that cause the outbreak of Hand-Foot-Mouth Disease (HFMD) in Hainan Province from 2010 to 2011 and to provide the etiological evidence for the diagnosis and control measures of HFMD in Hainan Province. Methods Based on the Handbook of Prevention and Control of Hand-Foot-Mouth Disease issued by the Ministry of Health, the handling of hand-foot-mouth cases and laboratory tests were performed. Real-time PCR was used to detect the DNA of the enterovirus universal primer, enterovirus 71 (EV71) and Coxsackie virus A16 (CoxA16), and the original sample with positive nucleic acid detection Inoculated human Rhabdomyosarcoma (RD cells) were isolated and cultured in enteroviruses. Representative strains were selected for virus gene sequence analysis. Results In 2010 and 2011, the prevalence of EV71 was 45.52% and 19.45% respectively in HFMH cases, while that of CoxA16 was only 6.9% and 4.7% respectively. The prevalences of CoxA16 in common cases were 19.63% and 24.8% %, EV71 infection rates were 16.34% and 6.36% respectively. The EV71 genotypes of Hainan Province were all C4a subtype in 2010 and 2011. The genotypes of CoxA16 virus include B1a and B1b. CoxA10, CoxA6 and CoxA4 also play important roles in CoxA5, CoxB1, CoxB2 and ECHO3 And ECHO 11 and other infections. The main pathogen of HFMD in Hainan Province was EV71, and a few cases were caused by CoxA16 infection. The infection rates of CoxA16 in severe cases in 2010 and 2011 were 6.9% and 4.7%, respectively. Moreover, the infection rates of CoxA10 and CoxA6 The proportion of severe cases than CoxA4 infection caused by a higher proportion of severe cases. Conclusion In 2010-2011, severe cases of hand, foot and mouth in Hainan Province were still infected with EV71. The infection rate of EV71 in normal cases decreased gradually and the infection rate of CoxA16 increased. The simultaneous presence of multiple enterovirus pathogens in Hainan population led to the continuous occurrence of HFMD and severe cases in Hainan Province. In particular, the CoxA10 and CoxA6 infections could easily lead to severe cases and deserve further research.