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目的对天津市2011年手足口病(HFMD)进行病原学检测,并对引起HFMD的肠道病毒71型(EV71)和柯萨奇病毒A组16型(CVA16)进行基因特征分析,为天津市HFMD的防控提供基础资料。方法采用Real time RT-PCR方法对HFMD疑似病例标本进行检测,用人横纹肌瘤(RD)细胞对部分阳性标本进行病毒分离;随机挑取16株EV71病毒分离株和9株CVA16病毒分离株,进行VP1区基因扩增,并进行核苷酸序列和遗传进化关系分析。结果共检测HFMD疑似病例1 853例,总阳性率为70.91%(1314/1853),其中EV71占49.10%,CVA16占21.61%,EV71和CVA16双阳性占0.91%,其他肠道病毒(EV)占28.46%。16株EV71分离株与C4a亚型代表株具有最高的核苷酸序列同源性(97.3%～99.1%),属于C4a基因亚型;9株CVA16分离株与B1b亚型代表株具有最高的核苷酸序列同源性(94.9%～95.4%),属于B1b基因亚型。结论 2011年引起天津市HFMD的EV71型病毒流行株为C4a基因亚型,CVA16型病毒流行株为B1b亚型,并兼有一定比例的其他肠道病毒。
Objective To analyze the etiology of hand-foot-mouth disease (HFMD) in 2011 in Tianjin and to analyze the genetic characteristics of HF71-induced enterovirus 71 (EV71) and Coxsackie virus A-type 16 (CVA16) HFMD prevention and control to provide the basic information. Methods Real-time reverse transcription-polymerase chain reaction (RT-PCR) was used to detect suspected cases of HFMD. Viruses were isolated from some positive specimens of rhabdomyosarcoma (RD) cells. Sixteen strains of EV71 and nine strains of CVA16 were randomly selected for VP1 Region gene amplification, and nucleotide sequence and genetic evolution relationship analysis. Results A total of 1 853 suspected HFMD cases were detected, with a total positive rate of 70.91% (1314/1853). EV71 accounted for 49.10%, CVA16 accounted for 21.61%, EV71 and CVA16 double positive accounted for 0.91%, and other enterovirus (EV) 28.46%. The 16 isolates of EV71 showed the highest nucleotide sequence homology (97.3% -99.1%) with the C4a subtype, which belonged to C4a subtype. The 9 isolates of CVA16 and B1b subtypes had the highest nucleus The nucleotide sequence homology (94.9% ~ 95.4%) belongs to B1b gene subtype. CONCLUSION: The epidemic strain of EV71 virus causing HFMD in Tianjin in 2011 was subtype C4a and the subtype of CVA16 virus was subtype B1b, with some other enterovirus.