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目的对广州市及周边地区手足口病(HFMD)的流行病学和病原学特征进行分析。方法收集2011年广州市及其周边地区手足口病病例968份,采用荧光定量RT-PCR方法对采集的标本进行肠道病毒(EV)核酸检测,将其分为肠道病71型(EV71)、萨克奇病毒A组16型(CA16)、非EV71、CA16阳性肠道病毒(N)三类,分离部分EV71毒株并进行全基因测序和分析。并用生物信息学软件进行病毒基因特征分析,经在线比对后进行EV型别鉴定。结果分析显示2011年广州市及周边地区HFMD的高发年龄段为年龄小于4岁的儿童,1～2岁婴幼儿发病率最高;5-7月为发病高峰期;EV71和CA16为HFMD的主要病原;但有24.79%的病例由其他肠道病毒(EV)型别引起。基于全基因序列构建种系发生进化树显示,所分离的6株EV71毒株与C4亚型毒株具有最近的亲缘性和最高的同源性。结论2011年EV71和CA16为广州市及周边地区流行的主要病原,EV71病毒株分离株属于C4型,且遗传性较稳定,但存在部分其他型别EV引起HFMD。
Objective To analyze the epidemiological and etiological characteristics of hand, foot and mouth disease (HFMD) in Guangzhou and surrounding areas. Methods A total of 968 cases of hand, foot and mouth disease in Guangzhou and its surrounding areas were collected in 2011. The collected samples were tested for enterovirus (EV) nucleic acid by fluorescence quantitative RT-PCR and divided into EV71, , Sarkoavirus A group 16 (CA16), non-EV71 and CA16 positive enterovirus (N). Some EV71 isolates were isolated and sequenced and analyzed. The bioinformatics software was used to analyze the characteristics of the virus gene. The EV type identification was performed after online comparison. The results showed that the incidence of HFMD was the highest in Guangzhou and surrounding areas in 2011, the highest incidence was found in infants aged 1-2 years, the peak incidence in May-July and EV71 and CA16 were the major pathogens of HFMD ; But 24.79% of cases were caused by other enterovirus (EV) types. The phylogenetic tree based on the complete genome sequence showed that the 6 isolated EV71 strains had the closest relatives and the highest homology with the C4 subtype strains. Conclusion EV71 and CA16 in 2011 are the major pathogens in Guangzhou and the surrounding areas. The isolates of EV71 strain belong to type C4, and their heredity is relatively stable. However, some other types of EV cause HFMD.