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本研究对上海市手足口病(Hand-foot-and-mouth disease,HFMD)的流行病学和病原学特征进行了分析。从国家疾病监测信息报告管理系统获取上海市2009年HFMD的流行病学数据;采用荧光定量RT-PCR方法对来自上海15个区县的799例HFMD进行肠道病毒(Enterovirus,EV)核酸检测;对部分肠道病毒71型(Enterovirus71,EV71)的VP1区和部分其它EV的VP4区序列进行测定和分析。采用Office excel软件进行简单数据统计分析,用BioEdit和MEGA软件进行病毒基因特征分析,通过BLAST服务器的在线比对进行EV型别鉴定。分析显示:上海市18个区县均有病例报告,地区分布无显著特点;小于6岁的婴幼儿期为疾病高发年龄段;4～7月为发病高峰期;EV71和柯萨奇病毒A16(Coxsackie virus A16,CA16)为主要病原,不同地区、不同月份的病原构成各不相同,CA16为轻症病例的主要病原,EV71则为重症病例的主要病原;基于VP1区序列分析,上海EV71毒株与C4a亚型毒株具有最近的亲缘性和最高的同源性;2株其它肠道病毒经鉴定属于CA2和CA10型。结果表明:EV71和CA16为2009年上海HFMD流行的主要病原,EV71属于C4a亚型;除EV71和CA16外,还存在小部分其它EV(如:CA2和CA10)引起的HFMD。
This study analyzed the epidemiological and etiological characteristics of Hand-foot-and-mouth disease (HFMD) in Shanghai. The epidemiological data of HFMD in Shanghai in 2009 were obtained from the National Disease Surveillance Information Reporting Management System; 799 cases of HFMD from 15 districts and counties in Shanghai were tested for Enterovirus (EV) nucleic acid by fluorescence quantitative RT-PCR; The VP1 region of partial enterovirus 71 (EV71) and some VP4 regions of other EVs were sequenced and analyzed. Using Office excel software for simple data statistical analysis, using BioEdit and MEGA software for virus gene signature analysis, through the BLAST server online comparison of EV type identification. The analysis showed that there were case reports in 18 districts and counties in Shanghai, with no obvious regional distribution. Infants and young children younger than 6 years old were the high-incidence age groups; 4 to 7 months were the peak incidence; EV71 and Coxsackie virus A16 Coxsackie virus A16, CA16) were the major pathogens, and the pathogens in different regions and months were different. CA16 was the main pathogen of mild cases and EV71 was the major pathogen of severe cases. Based on VP1 region analysis, Shanghai EV71 strain It has the closest and highest homology with the C4a subtype and two other enteroviruses have been identified as CA2 and CA10. The results showed that EV71 and CA16 were the major pathogens of HFMD epidemic in Shanghai in 2009, and EV71 belonged to C4a subtype. In addition to EV71 and CA16, there were a small number of HFMD caused by other EVs (such as CA2 and CA10).