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目的:了解2010年湖南省郴州市手足口病的病原学特征,为手足口病的防控工作提供依据。方法:采集2010年郴州市手足口病患者的咽拭子、肛拭子或粪便标本,采用Real time-RT-PCR方法检测HEV71、CVA16和HEV的核酸,选择HEV71阳性的标本使用RD、Vero细胞进行病毒分离,使用RT-PCR法扩增HEV71分离株的VP1区片段,进行VP1区核苷酸序列测定和分析。结果:2010年共检测手足口病患者临床标本665份,HEV阳性率72.78%,其中HEV71占55.17%、CVA16占18.59%、其它HEV占26.24%。不同月份、年龄、地区以及不同类型病例HEV型别构成比差异有统计学意义。分离出4株HEV71,其VP1区核苷酸序列分析表明为C4基因亚型。结论:HEV71为郴州市2010年手足口病流行的主要病原体,属于C4基因亚型。HEV71和CVA16的分布在病例发病时间,发病年龄和地域上有所不同。
Objective: To understand the etiological characteristics of hand-foot-mouth disease in Chenzhou city of Hunan province in 2010 and provide basis for the prevention and control of hand-foot-mouth disease. Methods: Throat swabs, anal swabs or stool specimens were collected from patients with hand-foot-mouth disease in Chenzhou in 2010. The nucleic acids of HEV71, CVA16 and HEV were detected by Real time-RT-PCR. HEV71-positive samples were selected using RD and Vero cells The virus was isolated. The VP1 region of HEV71 isolate was amplified by RT-PCR, and the VP1 region was sequenced and analyzed. Results: In 2010, a total of 665 clinical samples of hand-foot-mouth disease were detected, the positive rate of HEV was 72.78%, of which 55.17% were HEV71, 18.59% were CVA16 and 26.24% were other HEV. There were significant differences in the HEV type composition in different months, ages, regions and different types of cases. Four HEV71 isolates were isolated and their VP1 nucleotide sequence analysis revealed a C4 subtype. Conclusion: HEV71 is the major pathogen of hand, foot and mouth disease epidemic in Chenzhou City in 2010 and belongs to C4 gene subtypes. The distribution of HEV71 and CVA16 in the onset of the case, age and geographical age vary.