Tian Huifang, Zhang Yong, Shi Yan, Li Xiujuan, Sun Qiang, Liu Li, Zhao Dong, Xu Baohong
Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang City, Hebei Province, People's Republic of China.
WHO WPRO Regional Polio Reference Laboratory and Key Laboratory for Medical Virology, National Health and Family Planning Commission of China; National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China.
PLoS One. 2017 May 9;12(5):e0176604. doi: 10.1371/journal.pone.0176604. eCollection 2017.
Large outbreaks of hand, foot, and mouth disease (HFMD) have repeatedly occurred in mainland of China since 2007. In this study, we investigated the epidemiological and aetiological characteristics of HFMD in Shijiazhuang City, one of the biggest northern cities of China. A total of 57,173 clinical HFMD cases, including 911 severe and 32 fatal cases, were reported in Shijiazhuang City during 2009-2012. The disease incidence peaked during March-July, with a small increase in the number of cases observed in November of each year. Seventeen potential HFMD-causing enterovirus serotypes were detected, with the most frequent serotypes being EV-A71 and CV-A16. CV-A10 was also a frequently detected causative serotype, and was associated with the second largest number of severe HFMD cases, following EV-A71. Phylogenetic analysis revealed that all EV-A71, CV-A16 and CV-A10 strains from Shijiazhuang City had co-evolved and co-circulated with those from other Chinese provinces. Our findings underscore the need for enhanced surveillance and molecular detection for HFMD, and suggest that EV-A71 vaccination may be an effective intervention strategy for HFMD prevention and vaccines against CV-A10 and CV-A16 are also urgently needed.
自2007年以来，中国大陆多次发生手足口病（HFMD）大规模疫情。在本研究中，我们调查了中国北方最大城市之一石家庄市手足口病的流行病学和病原学特征。2009年至2012年期间，石家庄市共报告了57173例临床手足口病病例，其中包括911例重症病例和32例死亡病例。该病发病率在3月至7月达到峰值，每年11月病例数略有增加。检测到17种可能导致手足口病的肠道病毒血清型，最常见的血清型是EV-A71和CV-A16。CV-A10也是一种常见的致病血清型，与仅次于EV-A71的第二多的重症手足口病病例相关。系统发育分析表明，石家庄市所有的EV-A71、CV-A16和CV-A10毒株都与中国其他省份的毒株共同进化和传播。我们的研究结果强调了加强手足口病监测和分子检测的必要性，并表明EV-A71疫苗接种可能是预防手足口病的有效干预策略，同时也迫切需要针对CV-A10和CV-A16的疫苗。
