【摘要】 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。更多还原

【Abstract】 To analyze the epidemiological and etiological characteristics of Hand-Foot-and-Mouth disease(HFMD) in Shanghai in 2009,epidemiological data was retrieved from the National Notifiable Disease Report System(NNDRS).Nucleic acid of enterovirus(EV) was detected by real-time RT-PCR from 799 HFMD cases from 15 districts/counties in Shanghai;the complete sequences ofVP1 encoding region of several identified EV71 strains and sequences of VP4 encoding region of several untyped EV were determined and analyzed.Analysis and summary of the epidemiological data was conducted with Microsoft Excel,and sequence analyses were conducted with both BioEdit and MEGA software.Untyped EV was identified through comparing the VP4 sequence to sequence database using BLAST online service.It was showed that all the 18 districts/counties had reported HFMD cases;children less than 6 years old were the most susceptible population group;the peak of epidemics of HFMD was from April to July;EV71 and Coxsackievirus A16(CA16) were the major pathogens for this epidemic,but the constituent ratio of EV71 and CA16 was different in different months and regions;CA16 infection was mainly responsible for the mild HFMD,but EV71 for most of the severe cases;EV71 strains of Shanghai were clustered with representatives of subgenotype C4a and showed the highest identity to them,based on the sequence analyses of VP1 encoding region;2 of the untyped EV were identified as CA2 and CA10 respectively.All the results indicated that EV71 and CA16 were the major pathogens for the epidemic of HFMD in Shanghai,2009;the circulating EV71 belonged to subgenotype C4a.Besides,other types of EV(for example:CA2 and CA10) were also responsible for a few of the HFMD cases.更多还原