【摘要】 目的 分析辽宁省1起手足口病（hand,foot,and mouth disease,HFMD）暴发疫情的流行病学及病原学特征，以期为该病防控策略的制定提供参考。方法 2022年，辽宁省大连市某幼儿园暴发1起HFMD疫情，共采集13名患者的粪便及咽拭子标本，进行核酸检测和病毒分离。阳性样本盲传3代后获得辽宁分离株，提取病毒核酸进行全基因组测序，测序结果于美国生物技术信息中心网站进行BLAST分析。从GenBank中下载柯萨奇病毒A组16型（Coxsackievirus A16,CVA16）流行株及其主要血清型原型株序列作为参考株，同时以肠道病毒A71(enterovirus A71,EVA71)原型株为组外类群，应用MEGA 5.2软件进行同源性分析，采用邻接法构建基因进化树，对辽宁分离株与不同国家或地区不同年份流行株的CVA16 VP1进行系统进化分析。结果 本次HFMD暴发疫情共报告19例患者，罹患率为7.45%，无重症及死亡病例报告；男性15例（占比78.95%），女性4例（占比21.05%）;4、5、6岁分别有4、9、6例；暴发时间为2022年6月14—21日，发病高峰在6月19日，出现10例，占病例总数的52.63%。共获得13株辽宁分离株，核苷酸序列同源性> 99.9%，与CVA16同源性最高，属于B1c亚群；VP1氨基酸序列相同，与原型株比较，于19处位点发生了突变。结论 本次HFMD暴发疫情是由同一CVA16传染源引起的，今后应加强对CVA16的长期监测，为HFMD疫情早期预警提供科学依据，降低发病率。更多还原

【Abstract】 Objective To analyze the epidemiological and etiological characteristics of an outbreak of hand, foot, and mouth disease(HFMD) in Liaoning Province, in order to provide a reference for the formulation of preventive strategies for HFMD.Methods An outbreak of HFMD occurred in a kindergarten in Dalian, Liaoning Province in 2022. The stool and throat swab specimens of 13 patients were collected for nucleic acid detection and enterovirus isolation. After three generations of blind transmission of positive samples, Liaoning isolates were obtained, and the virus nucleic acid was extracted for genome sequencing. The sequencing results were analyzed by BLAST on the website of National Center for Biotechnology Information(NCBI). The VP1 sequences of Coxsackievirus A16(CVA16) epidemic strains and its main serotype prototype strains were downloaded from GenBank as reference strains, and enterovirus A71(EVA71) prototype strainwas taken as an outgroup taxon, which were analyzed for the homology by MEGA 5.2 software. The genetic phylogenetic tree was constructed by neighbor joining, and the phylogenetic analysis of CVA16 VP1 of Liaoning isolates and epidemic strains from different countries or regions in different years was performed. Results A total of 19 patients were reported in this HFMD outbreak, with an attack rate of 7. 45%, and no severe cases or deaths were reported; there were 15 males(accounting for 78. 95%) and 4females(accounting for 21. 05%); there were 4, 9 and 6 cases at the age of 4, 5 and 6 respectively. The outbreak time was from June 14 to 21, 2022, and the peak incidence occurred on June 19, with 10 cases, accounting for 52. 63% of the total cases. A total of 13 Liaoning isolates were obtained, with nucleotide homology of more than 99. 9%, and had the highest sequence homology with CVA16, belonging to sub-genotype B1c. The amino acid sequences of VP1 were almost identical,and mutations occurred at 19 amino acid sites compared with the prototype strain. Conclusion This HFMD epidemic was caused by the same CVA16 pathogen. In the future, the long-term monitoring of CVA16 should be strengthened to provide scientific basis for early warning of HFMD epidemic and reduce the incidence.更多还原