Zhu Shuang-Li, Liu Jian-Feng, Sun Qiang, Li Jing, Li Xiao-Lei, Zhang Yong, Chen Ying, Wen Xiao-Yun, Yan Dong-Mei, Huang Guo-Hong, Zhang Bao-Min, Zhang Bo, An Hong-Qiu, Li Hui, Xu Wen-Bo
WHO WPRO Regional Polio Reference Laboratory, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control Prevention, Beijing 102206, China.
Bing Du Xue Bao. 2013 Jun;29(4):415-20.
An epidemic of rash and fever illnesses suspected of hand, foot and mouth disease (HFMD) occurred in Gansu Province of China in 2008, laboratory tests were performed in order to identify the pathogen that caused this epidemic. Eight clinical specimens collected from the 4 patients (each patient has throat swab and herpes fluid specimens) with rash and febrile illness, were inoculated onto RD and HEp-2 cells for virus isolation, and the viral nucleic acid was then extracted with the positive virus isolates, the dual-channel real-time reverse transcript-polymerase chain reaction (RT-PCR) was performed to detect the nucleic acid of human enterovirus (HEV) in the viral isolates at the same time. For the viral isolates with the negative results of HEV, a sequence independent single primer amplification technique (SISPA) was used for "unknown pathogen" identification. Totally, 6 viral isolates were identified as herpes simplex virus type 1 (HSV-1). Comprehensive analyses results of the clinical manifestations of the patients, epidemiological findings and laboratory test indicated that this epidemic of rash and febrile illness was caused by HSV-1. The differences among the gG region of 6 HSV-1 isolates at nucleotide level and amino acid level were all small, and the identities were up to 98. 8% and 97.9%, respectively, showing that this outbreak was caused by only one viral transmission chain of HSV-1. HSV-1 and other viruses that cause rash and febrile illnesses need differential diagnosis with HFMD. The etiology of rash and febrile illness is sometimes difficult to distinguish from the clinical symptoms and epidemiological data, the laboratory diagnosis is therefore critical.
2008年中国甘肃省发生了疑似手足口病（HFMD）的皮疹和发热疾病疫情，为鉴定引发此次疫情的病原体进行了实验室检测。从4例患有皮疹和发热疾病的患者（每位患者有咽拭子和疱疹液标本）采集的8份临床标本，接种于RD和HEp-2细胞进行病毒分离，然后用阳性病毒分离株提取病毒核酸，同时进行双通道实时逆转录聚合酶链反应（RT-PCR）检测病毒分离株中的人肠道病毒（HEV）核酸。对于HEV检测结果为阴性的病毒分离株，采用序列非依赖单引物扩增技术（SISPA）进行“未知病原体”鉴定。共鉴定出6株病毒分离株为1型单纯疱疹病毒（HSV-1）。对患者临床表现、流行病学调查结果和实验室检测的综合分析结果表明，此次皮疹和发热疾病疫情是由HSV-1引起的。6株HSV-1分离株gG区在核苷酸水平和氨基酸水平的差异均较小，同一性分别高达98.8%和97.9%，表明此次疫情是由HSV-1的单一病毒传播链引起的。HSV-1与其他引起皮疹和发热疾病的病毒需要与手足口病进行鉴别诊断。皮疹和发热疾病的病因有时难以从临床症状和流行病学资料中区分，因此实验室诊断至关重要。
