National Institute for Health and Welfare (THL), Department of Infectious Disease Surveillance and Control, Gastrointestinal Infections Unit, PO Box 30, 00271 Helsinki, Finland.
J Clin Virol. 2010 May;48(1):49-54. doi: 10.1016/j.jcv.2010.02.002. Epub 2010 Feb 26.
A nationwide outbreak of hand, foot and mouth disease (HFMD) occurred in Finland in autumn 2008. The outbreak was untypical since a considerable number of clinically diagnosed patients were adults. Furthermore, many of the patients suffered from onychomadesis several weeks after the acute phase of HFMD.
Detection, identification and phylogenetic analysis of human enteroviruses (HEV) that caused the outbreak.
A total of 420 clinical specimens were obtained from 317 HFMD cases all over the country. The presence of HEV in the specimens was analysed by virus isolation and/or direct real-time RT-PCR; selected HEV strains were further typed by molecular methods. The genetic similarities of HEV strains were assessed by phylogenetic analyses on partial VP1 sequences.
HEV were detected in 212 HFMD cases, including both children and adults, throughout Finland. Two HEV types, coxsackieviruses A6 (CV-A6) and A10 (CV-A10), were identified as the causative agents of the outbreak. One genetic variant of CV-A6 predominated, but, additionally, three other genetically distinct CV-A6 strains were found. All CV-A10 strains segregated into one genetic cluster distinct from previously reported CV-A10 sequences.
The Finnish 2008 HFMD outbreak was caused by two infrequently detected, co-circulating, coxsackie A viruses. Our data suggest endemic circulation of both CV-A types in Northern Europe and that the outbreak was due to the emergence of new genetic variants of these viruses.
2008 年秋季，芬兰发生了一场全国性的手足口病（HFMD）疫情。此次疫情较为特殊，因为相当数量的临床诊断患者为成年人。此外，许多患者在 HFMD 的急性阶段过后数周出现了甲营养不良。
检测、鉴定并对引发此次疫情的人类肠道病毒（HEV）进行系统发育分析。
从全国各地的 317 例 HFMD 患者中采集了总共 420 份临床标本。通过病毒分离和/或直接实时 RT-PCR 分析标本中 HEV 的存在情况；通过分子方法对选定的 HEV 株进行进一步分型。通过对部分 VP1 序列进行系统发育分析，评估 HEV 株之间的遗传相似性。
在芬兰全国各地的 212 例 HFMD 病例中均检测到了 HEV，包括儿童和成年人。鉴定出两种肠道病毒，柯萨奇病毒 A6（CV-A6）和 A10（CV-A10），为此次疫情的病原体。一种 CV-A6 的遗传变异株占主导地位，但同时还发现了另外三种具有不同遗传特征的 CV-A6 株。所有 CV-A10 株都聚类为一个不同于先前报道的 CV-A10 序列的遗传簇。
芬兰 2008 年 HFMD 疫情是由两种不常检测到的、共同循环的柯萨奇 A 病毒引起的。我们的数据表明，这两种 CV-A 型病毒在北欧地区存在地方性流行，并且此次疫情是由这些病毒的新遗传变异株引起的。
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