Zhang Xiaoai, Wang Hongyu, Ding Shujun, Wang Xianjun, Chen Xiaodan, Wo Ying, Wang Liyuan, Huang Doudou, Liu Wei, Cao Wuchun
State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing 100071, P, R, China.
BMC Infect Dis. 2013 Dec 27;13:606. doi: 10.1186/1471-2334-13-606.
To determine the prevalence of human enteroviruses (HEVs) among healthy children, their parents, and children with hand, foot, and mouth disease (HFMD).
We conducted a case-control study that included throat samples from 579 children with HFMD and from 254 healthy controls. Throat samples from 49 households (98 parents and 53 healthy children) were also analyzed. Phylogenetic analysis was carried out to study genetic relationships of EV71 strains.
The HEV positive rate in HFMD patients was significantly higher than that in healthy controls (76.0% vs. 23.2%, P < 0.001). The EV71 (43.7% vs. 15.0%, P < 0.001), CVA16 (18.0% vs. 2.8%, P < 0.001), and CVA10 (5.7% vs. 0.8%, P = 0.001) serotypes were significantly overrepresented in HFMD patients in comparison to healthy children. Other HEV serotypes were detected with comparable frequency in cases and controls. The HEV positive rate in severe HFMD patients was significantly higher than that in mild group (82.1% vs. 73.8%, P = 0.04). The EV71 (55.0% vs. 39.7%, P = 0.001) and CVA16 (11. 9% vs. 20.0%, P = 0.024) positive rate differed significantly between severe and mild HFMD patients. Other HEV serotypes were detected with comparable frequency between severe and mild HFMD patients. Among 49 households, 22 households (44.9%) had at least 1 family member positive for HEV. Children had significantly higher HEV positive rate than adult (28.3% vs. 14.3%, P = 0.037). The HEV positive rate was similar between mothers and fathers (12.24% vs. 16.32%, P = 0.56). The VP1 sequences of EV71 from HFMD patients and healthy children were nearly identical and all were clustered in the same clade, C4a.
Our study demonstrated the co-circulation of multiple HEV serotypes in children with and without HFMD during epidemic. Our study deserves the attention on HFMD control.
确定健康儿童、其父母以及手足口病（HFMD）患儿中人类肠道病毒（HEV）的流行情况。
我们进行了一项病例对照研究，纳入了579例手足口病患儿和254例健康对照的咽拭子样本。还分析了49户家庭（98名父母和53名健康儿童）的咽拭子样本。进行系统发育分析以研究EV71毒株的遗传关系。
手足口病患者中HEV阳性率显著高于健康对照（76.0%对23.2%，P<0.001）。与健康儿童相比，手足口病患者中EV71（43.7%对15.0%，P<0.001）、CVA16（18.0%对2.8%，P<0.001）和CVA10（5.7%对0.8%，P=0.001）血清型的比例显著过高。病例组和对照组中检测到的其他HEV血清型频率相当。重症手足口病患者的HEV阳性率显著高于轻症组（82.1%对73.8%，P=0.04）。重症和轻症手足口病患者之间EV71（55.0%对39.7%，P=0.001）和CVA16（11.9%对20.0%，P=0.024）阳性率差异显著。重症和轻症手足口病患者中检测到的其他HEV血清型频率相当。在49户家庭中，22户（44.9%）至少有1名家庭成员HEV阳性。儿童的HEV阳性率显著高于成人（28.3%对14.3%，P=0.037）。母亲和父亲的HEV阳性率相似（12.24%对16.32%，P=0.56）。手足口病患者和健康儿童的EV71的VP1序列几乎相同，均聚集在同一进化枝C4a中。
我们的研究表明，在流行期间，手足口病患儿和非手足口病患儿中多种HEV血清型共同流行。我们的研究值得对手足口病防控予以关注。
