Teng Zheng, Tan Xiao-Juan, Shao Jun-Jie, Zhang Yong, Kuang Xiao-Zhou, Zhang Xi, Xu Wen-Bo
Department of Microbiology, Shanghai Center for Disease Control and Prevention, Shanghai 200336, China.
Bing Du Xue Bao. 2010 Nov;26(6):437-42.
To analyze the epidemiological and etiological characteristics of Hand-Foot-and-Mouth disease (HFMD) in Shanghai in 2009, epidemiological data was retrieved from the National Notifiable Disease Report System (NNDRS). Nucleic acid of enterovirus (EV) was detected by real-time RT-PCR from 799 HFMD cases from 15 districts/counties in Shanghai; the complete sequences of VP1 encoding region of several identified EV71 strains and sequences of VP4 encoding region of several untyped EV were determined and analyzed. Analysis and summary of the epidemiological data was conducted with Microsoft Excel, and sequence analyses were conducted with both BioEdit and MEGA software. Untyped EV was identified through comparing the VP4 sequence to sequence database using BLAST online service. It was showed that all the 18 districts/counties had reported HFMD cases; children less than 6 years old were the most susceptible population group; the peak of epidemics of HFMD was from April to July; EV71 and Coxsackievirus A16 (CA16) were the major pathogens for this epidemic, but the constituent ratio of EV71 and CA16 was different in different months and regions; CA16 infection was mainly responsible for the mild HFMD, but EV71 for most of the severe cases; EV71 strains of Shanghai were clustered with representatives of subgenotype C4a and showed the highest identity to them, based on the sequence analyses of VP1 encoding region; 2 of the untyped EV were identified as CA2 and CA10 respectively. All the results indicated that EV71 and CA16 were the major pathogens for the epidemic of HFMD in Shanghai, 2009; the circulating EV71 belonged to subgenotype C4a. Besides, other types of EV (for example: CA2 and CA10) were also responsible for a few of the HFMD cases.
为分析2009年上海市手足口病（HFMD）的流行病学及病原学特征，从国家法定传染病报告系统（NNDRS）检索流行病学数据。采用实时荧光定量逆转录聚合酶链反应（RT-PCR）对上海市15个区县799例手足口病病例进行肠道病毒（EV）核酸检测；对部分鉴定出的EV71毒株的VP1编码区全序列及部分未分型EV的VP4编码区序列进行测定与分析。利用Microsoft Excel对流行病学数据进行分析汇总，采用BioEdit和MEGA软件进行序列分析。通过在线BLAST服务将VP4序列与序列数据库进行比对鉴定未分型EV。结果显示，上海市18个区县均有手足口病病例报告；6岁以下儿童为最易感人群；手足口病流行高峰为4至7月；EV71和柯萨奇病毒A16（CA16）为本次流行的主要病原体，但不同月份和地区EV71与CA16的构成比不同；CA16感染主要引起轻症手足口病，而EV71感染多导致重症病例；基于VP1编码区序列分析，上海市EV71毒株与C4a亚型代表株聚类，同源性最高；2株未分型EV分别鉴定为CA2和CA10。所有结果表明，EV71和CA16是2009年上海市手足口病流行的主要病原体；流行的EV71属于C4a亚型。此外，其他类型的EV（如CA2和CA10）也引起了少数手足口病病例。
