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山东大学学报 (医学版) ›› 2019, Vol. 57 ›› Issue (11): 90-97.doi: 10.6040/j.issn.1671-7554.0.2019.558

• 公共卫生与管理学 • 上一篇    

济南市2012~2017年手足口病肠道病毒谱变化及流行特征

关恒云,王春荣,刘岚铮,杨国樑,赵怀龙,孙洁,成洪旗   

  1. 济南市疾病预防控制中心1.病毒性疾病检验所;2.细菌性疾病检验所, 山东 济南 250021
  • 发布日期:2022-09-27
  • 通讯作者: 刘岚铮. E-mail: jncdcllz@jn.shandong.cn
  • 基金资助:
    山东省医药卫生科技发展计划(2016WS0116);山东省医药卫生科技发展计划(2017WS529)

Changes of enterovirus spectrum and epidemiological characteristics of hand, foot and mouth disease in Jinan, China, 2012-2017

GUAN Hengyun, WANG Chunrong, LIU Lanzheng, YANG Guoliang, ZHAO Huailong, SUN Jie, CHENG Hongqi   

  1. 1. Viral Disease Inspection Laboratory;
    2. Bacterial Disease Inspection Laboratory, Jinan Center for Disease Control and Prevention, Jinan 250021, Shandong, China
  • Published:2022-09-27

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摘要： 目的 阐明济南市手足口病肠道病毒病原谱的构成及变化,探索不同肠道病毒类型的流行特征。 方法 收集2012年1月~2017年12月济南市手足口病标本4 929例,采用实时荧光定量逆转录-聚合酶链反应(RT-PCR)方法检测EV-A71、柯萨奇病毒A组16型(CV-A16)、柯萨奇病毒A组6型(CV-A6)和柯萨奇病毒A组10型(CV-A10);对肠道病毒通用(PE)阳性而未明确分型标本采用巢式RT-PCR方法,扩增肠道病毒5'-非翻译区(5'-UTR),经核苷酸序列测定明确肠道病毒类型。 结果 4 929例标本中共检出27种肠道病毒类型,除EV-A71、CV-A16、CV-A6和CV-A10外,柯萨奇病毒A组(CV-A2、4、5、9、12、13、21、22、24)、柯萨奇病毒B组(CV-B1~5)、埃可病毒(E3、6、7、9、11、18、24、25、30)均有检出。轻型病例肠道病毒感染率居前4位的是CV-A16(29.03%)、EV-A71(25.67%)、CV-A6(17.58%)和CV-A10(3.10%),重症病例为EV-A71(77.64%)、CV-A16(5.59%)、CV-A6(1.86%)和CV-A10(1.24%)。CV-A6和CV-A10感染者的发病年龄较EV-A71和CV-A16感染者略小,分别为(3.02±2.43)岁、(2.87±1.67)岁、(3.29±2.34)岁和(3.36±2.18)岁,差异有统计学意义(F=3.659,P=0.003)。流行季节研究显示,EV-A71和CV-A16发病高峰为第2或4季度,CV-A6好发于6~12月份,CV-A10病例6~8月份发病较多。平阴县和章丘区肠道病毒阳性检出率较高,分别为93.49%和91.99%。 结论 济南市手足口病肠道病毒谱以EV-A71、CV-A16、CV-A6和CV-A10为优势型别,27种肠道病毒共存。常年监测非EV-A71非CV-A16肠道病毒的流行特征,及时掌握肠道病毒谱变化,有助于及时完善手足口病疫情的防控措施。

关键词: 手足口病, 肠道病毒, 病原谱, 流行特征

Abstract: Objective To clarify the composition and changes of enterovirus spectrum in hand, foot and mouth disease in Jinan, China, from Jan. 2012 to Dec. 2017, further to analyze the epidemiological characteristics of different types of enterovirus. Methods A total of 4 929 specimens were collected from clinically diagnosed hand, foot and mouth disease cases in Jinan from 2012 to 2017. All specimens were detected for Enterovirus A71(EV-A71), Coxsackievirus(CV)-A16, CV-A6 and CV-A10 by real-time reverse transcription-polymerase chain reaction(RT-PCR). For unclassified specimens, reverse transcription nested PCR based on the 5'-untranslated region(5'-UTR)sequence was performed and the types of enterovirus were determined by nucleotide sequencing. Results A total of 27 types of enterovirus were identified in 4 929 specimens, including not only EV-A71, CV-A16, CV-A6 and CV-A10, but also CV-A2, 4, 5, 9, 12, 13, 21, 22, 24, CV-B1-5 and E3, 6, 7, 9, 11, 18, 24, 25, 30. The constituent ratios were different between 山 东 大 学 学 报 (医 学 版)57卷11期 -关恒云,等.济南市2012~2017年手足口病肠道病毒谱变化及流行特征 \=-mild and severe cases. The top four types of enterovirus for mile cases were CV-A16(29.03%), EV-A71(25.67%), CV-A6(17.58%)and CV-A10(3.10%), and for severe cases were EV-A71(77.64%), CV-A16(5.59%), CV-A6(1.86%)and CV-A10(1.24%). The cases with CV-A6 and CV-A10 infections were younger than EV-A71 and CV-A16 infections(F=3.659, P=0.003), and they were(3.02±2.43),(2.87±1.67),(3.29±2.34)and(3.36±2.18)years, respectively. The incidence peak of EV-A71 and CV-A16 appeared usually in the second or fourth quarter, CV-A6 mostly occurred from June to December, and CV-A10 from June to August. The positive detection rate of enteroviruses was higher in Pingyin county and Zhangqiu district(93.49% and 91.99%, respectively). Conclusion EV-A71, CV-A16, CV-A6 and CV-A10 were the dominant types of enteroviruses associated with hand, foot and mouth disease in Jinan, and 27 types of enteroviruses coexisted from 2012 to 2017. The epidemiological characteristics of non-EV-A71 and non-CV-A16 enterovirus should be monitored year-by-year. To clarify the changes of enterovirus spectrum clearly will help health authorities to early provide prevention and control measures for epidemics.

Key words: Hand, foot and mouth disease, Enterovirus, Pathogenic spectrum, Epidemic characteristic

中图分类号: 

  • R115
[1] 郭悦,韩桃利,黄晓霞,等.2008-2016年我国手足口病突发公共卫生事件报告分析[J].病毒学报, 2017, 33(6): 880-885. GUO Yue, HAN Taoli, HUANG Xiaoxia, et al. Analyses of reported public-health emergency events of hand, foot and mouth disease in China, 2008-2016[J]. Chinese Journal of Virology, 2017, 33(6): 880-885.
[2] ICTV. The Online(10th)Report of the International Committee on Taxonomy of Viruses [EB/OL].https://talk.ictvonline.org/ictv-reports/ictv_online_report/positive-sense-rna viruses/picornavirales/w/picornaviridae/681/genus-enterovirus, 2019-05-17.
[3] Zhu Z, Zhu S, Guo X, et al. Retrospective seroepidemiology indicated that human enterovirus 71 and coxsackievirus A16 circulated wildly in central and southern China before large-scale outbreaks from 2008[J]. Virol J, 2010, 7: 300. doi: 10.1186/1743-422X-7-300.
[4] Xing W, Liao Q, Viboud C, et al. Hand, foot, and mouth disease in China, 2008-12: an epidemiological study[J]. Lancet Infect Dis, 2014, 14(4): 308-318.
[5] Van HMT, Anh NT, Hong NTT, et al. Enterovirus A71 phenotypes causing hand, foot and mouth disease, Vietnam[J]. Emerg Infect Dis, 2019, 25(4): 788-791.
[6] Noisumdaeng P, Korkusol A, Prasertsopon J, et al. Longitudinal study on enterovirus A71 and coxsackievirus A16 genotype/subgenotype replacements in hand, foot and mouth disease patients in Thailand, 2000-2017[J]. Int J Infect Dis, 2019, 80: 84-91. doi: 10.1016/j.ijid.2018.12.020.
[7] Horsten HH, Kemp M, Fischer TK, et al. Atypical hand, foot, and mouth disease caused by coxsackievirus A6 in Denmark: a diagnostic mimicker[J]. Acta Derm Venereol, 2018, 98(3): 350-354.
[8] 曾汉日,郑焕英,刘冷,等. 2010-2016年广东省手足口病非EV71非CVA16肠道病毒病原谱分析[J].国际病毒学杂志, 2018, 25(6): 374-378. ZENG Hanri, ZHENG Huanying, LIU Leng, et al. Analysis of non-EV71, non-CVA16 enterovirus among HFMD cases in Guangdong province in 2010-2016[J]. International Journal of Virology, 2018, 25(6): 374-378.
[9] Yoshitomi H, Ashizuka Y, Ichihara S, et al. Molecular epidemiology of coxsackievirus A6 derived from hand, foot, and mouth disease in Fukuoka between 2013 and 2017[J]. J Med Virol, 2018, 90(11): 1712-1719.
[10] Kimmis BD, Downing C, Tyring S. Hand-foot-and-mouth disease caused by coxsackievirus A6 on the rise[J]. Cutis, 2018, 102(5): 353-356.
[11] 中华人民共和国卫生部. 手足口病预防控制指南(2009版)[EB/OL]. http://www.gov.cn/gzdt/2009-06/04/content_1332078.htm, 2019-05-17.
[12] 关恒云,王春荣,吕燕,等. 2012年济南市手足口病病原学及流行特征[J].山东大学学报(医学版), 2013, 51(10): 101-104. GUAN Hengyun, WANG Chunrong, LV Yan, et al. Etiology and epidemiological characteristics of hand-foot-mouth disease in Jinan in 2012[J]. Journal of Shandong University(Health Science), 2013, 51(10): 101-104.
[13] Ge S, Yan Q, He S, et al. Specific primer amplification of the VP1 region directed by 5UTR sequence analysis: enterovirus testing and identification in clinical samples from hand-foot-and-mouth disease patients[J]. J Virol Methods, 2013, 193(2): 463-469.
[14] 钱素云,李兴旺.我国手足口病流行及诊治进展十年回首[J].中华儿科杂志, 2018, 56(5): 321-323.
[15] 谢群,刘爱平,谭徽,等. 2013-2015年郴州市手足口病病原谱及柯萨奇病毒A6基因特征分析[J].实用预防医学, 2018, 25(11): 1286-1289. XIE Qun, LIU Aiping, TAN Hui, et al. Pathogenic spectrum of hand,foot,and mouth disease and genetic characteristics of coxasckievirus A6 in Chenzhou City, 2013-2015[J]. Practical Preventive Medicine, 2018, 25(11): 1286-1289.
[16] 张晓玲,俞慧菊,刘祎,等.2011-2016年上海地区手足口病病原谱及柯萨奇病毒A组6型不同基因型感染细胞的差异研究[J].微生物与感染, 2018, 13(2): 84-89. ZHANG Xiaoling, YU Huiju, LIU Yi, et al. Pathogen spectrum and characterization of hand, foot and mouth disease from 2011 to 2016 in Shanghai[J]. Journal of Microbes and Infections, 2018, 13(2): 84-89.
[17] Feng X, Guan W, Guo Y, et al. A novel recombinant lineages contribution to the outbreak of coxsackievirus A6-associated hand, foot and mouth disease in Shanghai, China, 2012-2013[J]. Sci Rep, 2015, 5:11700. doi: 10.1038/srep11700.
[18] 王冰,张春青,王萍,等.2013-2017年沈阳市手足口病病原谱特征及流行病学分析[J].国际病毒学杂志, 2018, 25(5): 334-338. WANG Bing, ZHANG Chunqing, WANG Ping, et al. Pathogenic spectrum and epidemiological analysis on hand, foot, and mouth disease in Shenyang from 2013 to 2017[J]. International Journal of Virology, 2018, 25(5): 334-338.
[19] 关君艳,詹飞,李俊华.两种病毒所致重症手足口病的临床特征比较分析[J].国际病毒学杂志, 2018, 25(5): 338-343. GUAN Junyan, ZHAN Fei, LI Junhua. Comparative analysis for clinical features of severe hand, foot and mouth disease caused by two viruses[J]. International Journal of Virology, 2018, 25(5): 338-343.
[20] 张芙荣.不同病原所致手足口病临床特征分析[J]. 临床医药文献电子杂志, 2018, 5(77): 60.
[21] 陈琦,邢学森,吴杨,等.湖北省2009-2015年手足口病流行病学和病原学分析[J].中华流行病学杂志, 2017, 38(4): 441-445. CHEN Qi, XING Xuesen, WU Yang, et al. Hand, foot and mouth disease in Hubei province, 2009-2015: an epidemiological and etiological Study[J]. Chinese Journal of Epidemiology, 2017, 38(4): 441-445.
[22] 马婉婉,吴家兵,孙良,等.阜阳市2008~2016年手足口病流行病学及病原学特征分析[J].安徽医科大学学报, 2018, 53(12): 1898-1902. MA Wanwan, WU Jiabing, SUN Liang, et al. Epidemiological and etiological characteristics of hand-foot-mouth disease in Fuyang City from 2008 to 2016[J]. Acta Universitatis Medicinalis Anhui, 2018, 53(12): 1898-1902.
[23] Gao L, Zou G, Liao Q, et al. Spectrum of enterovirus serotypes causing uncomplicated hand, foot, and mouth disease and enteroviral diagnostic yield of different clinical samples[J]. Clin Infect Dis, 2018, 67(11): 1729-1735.
[24] Mao QY, Wang Y, Bian L, et al. EV71 vaccine, a new tool to control outbreaks of hand, foot and mouth disease(HFMD)[J]. Expert Rev Vaccines, 2016, 15(5): 599-606.
[25] 范学志.手足口病动态传播特性分析[D].青岛:青岛大学, 2018.
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