柯萨奇病毒 A16 感染爆发：与台北一所幼儿园其他肠病毒的比较。

An outbreak of coxsackievirus A16 infection: comparison with other enteroviruses in a preschool in Taipei.

机构信息

Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, 7 Chung-Shan South Road, Taipei, Taiwan.

出版信息

J Microbiol Immunol Infect. 2010 Aug;43(4):271-7. doi: 10.1016/S1684-1182(10)60043-6.

DOI:10.1016/S1684-1182(10)60043-6

PMID:20688286

Abstract

BACKGROUND/PURPOSE: The transmission rate of enteroviruses in young children remains unclear. Therefore, we carried out active surveillance in preschool children to investigate the transmission rate and clinical manifestation of enteroviruses.

METHODS

From September 2006 to December 2008, we monitored infectious diseases in children 2(-3 years of age) in a preschool in Taipei. If any child had a febrile illness or symptoms/signs of enteroviral infection [e.g. herpangina or hand-foot-and-mouth disease (HFMD)], we performed viral isolation and enterovirus polymerase chain reaction. VP1 sequencing was performed to define their serotypes. We also collected clinical data and analyzed transmission rates.

RESULTS

There were eight episodes of enterovirus infection during the study period. The serotypes included coxsackievirus A4 (CA4), CA2 and CA16. The transmission rates of CA4 and CA2 among children in same class were 26% and 35%, respectively. Between November 28 and December 12, 2008, 13/21 (61.9%) children contracted herpangina and/or HFMD. The average age was 2.82 (range, 2.43-3.39) years. CA16 was detected in 10/13 (76.9%) of the throat swabs by polymerase chain reaction VP1 genotyping. Compared with previous CA2 and CA4 outbreaks, CA16 had a significantly higher transmission rate (p = 0.035) and resulted in more cases of HFMD (p < 0.001). The transmission duration of coxsackie A viruses within the same class ranged from 12 to 40 days.

CONCLUSION

Compared with CA2 and CA4, CA16 infections resulted in more cases of HFMD and had significantly higher transmission rates in preschoolers.

摘要

背景/目的：肠道病毒在幼儿中的传播率尚不清楚。因此，我们对学龄前儿童进行了主动监测，以调查肠道病毒的传播率和临床表现。

方法

2006 年 9 月至 2008 年 12 月，我们监测了台北一所幼儿园 2(-3 岁)岁儿童的传染病情况。如果任何儿童出现发热或肠道病毒感染的症状/体征[例如疱疹性咽峡炎或手足口病（HFMD）]，我们进行病毒分离和肠道病毒聚合酶链反应。VP1 测序用于确定血清型。我们还收集了临床数据并分析了传播率。

结果

研究期间发生了 8 次肠道病毒感染。血清型包括柯萨奇病毒 A4（CA4）、CA2 和 CA16。同班级 CA4 和 CA2 的传播率分别为 26%和 35%。2008 年 11 月 28 日至 12 月 12 日，13/21（61.9%）名儿童患疱疹性咽峡炎和/或手足口病。平均年龄为 2.82 岁（范围 2.43-3.39 岁）。13 例咽拭子中通过聚合酶链反应 VP1 基因分型检测到 10 例（76.9%）CA16。与之前的 CA2 和 CA4 爆发相比，CA16 的传播率明显更高（p=0.035），HFMD 病例更多（p<0.001）。同班级柯萨奇 A 病毒的传播持续时间为 12 至 40 天。