中国襄阳肠道病毒 71 型疫苗后手足口病的流行病学和病因学研究。
Epidemical and etiological study on hand, foot and mouth disease following EV-A71 vaccination in Xiangyang, China.
机构信息
Wuhan Institute of Biological Products Co. Ltd, Wuhan, 430207, China.
National Engineering Technology Research Center of Combined Vaccines, No.1 Huangjin Industrial Park, Wuhan, 430207, Hubei, China.
出版信息
Sci Rep. 2020 Dec 1;10(1):20909. doi: 10.1038/s41598-020-77768-7.
Coxsackievirus A6 (CV-A6) and Coxsackievirus A10 (CV-A10) have been emerging as the prevailing serotypes and overtaking Enterovirus A71 (EV-A71) and Coxsackievirus A16 (CV-A16) in most areas as main pathogens of hand, foot and mouth disease (HFMD) in China since 2013. To investigate whole etiological spectrum following EV-A71 vaccination of approximate 40,000 infants and young children in Xiangyang, enteroviruses were serotyped in 4415 HFMD cases from October 2016 to December 2017 using Real Time and conventional PCR and cell cultures. Of the typeable 3201 specimen, CV-A6 was the predominant serotype followed by CV-A16, CV-A10, CV-A5, CV-A2 and EV-A71 with proportions of 59.54%, 15.31%, 11.56%, 4.56%, 3.78% and 3.03%, respectively. Other 12 minor serotypes were also detected. The results demonstrated that six major serotypes of enteroviruses were co-circulating, including newly emerged CV-A2 and CV-A5. A dramatic decrease of EV-A71 cases was observed, whereas the total cases remained high. Multivalent vaccines against major serotypes are urgently needed for control of HFMD.
自 2013 年以来，柯萨奇病毒 A6（CV-A6）和柯萨奇病毒 A10（CV-A10）已成为中国手足口病（HFMD）的主要病原体，取代了肠道病毒 A71（EV-A71）和柯萨奇病毒 A16（CV-A16）。为了研究 EV-A71 疫苗接种后近 4 万名婴幼儿的全病因谱，2016 年 10 月至 2017 年 12 月，使用实时和常规 PCR 及细胞培养对襄阳市 4415 例 HFMD 病例中的肠道病毒进行了血清型鉴定。在可分型的 3201 份标本中，CV-A6 是主要血清型，其次是 CV-A16、CV-A10、CV-A5、CV-A2 和 EV-A71，比例分别为 59.54%、15.31%、11.56%、4.56%、3.78%和 3.03%。还检测到其他 12 种次要血清型。结果表明，六种主要肠道病毒血清型同时流行，包括新出现的 CV-A2 和 CV-A5。EV-A71 病例明显减少，而总病例数仍居高不下。迫切需要针对主要血清型的多价疫苗来控制 HFMD。
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