2011年广州市手足口病病原谱分析

目的了解引起2011年广州市手足口病流行的病原体,确定其型别分布特征。方法收集手足口病疑似病例标本,用Real-time RT-PCR、巢式RT-PCR方法对其部分VP1基因进行扩增并测序,确定其病原谱构成,构建系统发育树。结果共收集2 067例疑似手足口病病例标本,其中实验室确诊肠道病毒阳性1 113份,包括EV71、CoxA16、CoxA6、CoxA10、CoxA9、HEV96、埃可病毒和柯萨奇B组等15种肠道病毒,其中EV71、CoxA16和CoxA6是主要病原体,分别占32.6%、39.2%和18.5%;死亡病例3例,全部由EV71引起;重症病例9例,6例由EV71引起,3例由CoxA6引起。VP1基因构建进化树分型发现,广州市2011年手足口病病原体属于HEV-A（97.2%）、HEV-B（2.5%）、HEV-C（0.3%）3个型别,未发现HEV-D型毒株。结论广州市2011年手足口病的流行主要由HEV-A型的EV71、CoxA16和CoxA6病毒引起,同时还存在HEV-B型和HEV-C型的CoxA9、EC、CoxB、CoxA24多种病毒。

Spectrum analysis of hand,foot and mouth disease in Guangzhou in 2011

Objective To identify the pathogens causing hand,foot and mouth disease（HFMD） in Guangzhou in 2011 and the distribution of their genotypes.Methods Specimens of suspected HFMD were collected.Partial VP1 genes were amplified by Real-Time RT-PCR or nested RT-PCR and then sequenced.Phylogenetic trees were constructed for correlation analysis.Results A total of 2 067 suspected HFMD cases were found.Enterovirus was identified in 1 139 cases,including 15 enteroviruses such as EV71,CoxA16,CoxA6,CoxA10,CoxA9,HEV96 and CoxB.CoxA16（39.2%）,EV71（32.6%） and CoxA6（18.5%） were the major pathogens causing HFMD.There were 3 fatal cases and 6 severe cases caused by EV71.3 severe cases were caused by CoxA6.Phylogenetic analysis indicated that all pathogens identified in this study could be classified into HEV-A（97.2%）,HEV-B（2.5%） and HEV-C（0.3%）.No HEV-D was found.Conclusion EV71,CoxA16 and CoxA6 were the major pathogens causing HFMD.They all belong to HEV-A.There were sporadic cases caused by HEV-B（CoxA9,EC,CoxB） and HEV-C（CoxA24）.