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为了探究2010年海南省手足口病(Hand-foot-and-mouth disease,HFMD)的流行病学及病原学特征,本研究对2010年海南省HFMD病例报告信息进行整理分析,并对2010年海南省18县市1346份HFMD病例临床标本进行肠道病毒(enterovirus,EV)实验室检测。核酸检测阳性标本进行EV分离和鉴定,对分离到的肠道病毒71型(Enterovirus 71,EV71)的VP1编码区全长基因进行扩增及序列测定,用Sequencher 5.0和MEGA 5.0等生物信息学软件基于VP1编码区进行EV71的分子流行病学分析。流行病学分析表明:全省18个县市均有病例报告,尤其以东北部县市高发,同时以4岁以下的婴儿为高发人群;而与全国大多省份流行规律不同的是其发病高峰期为9和10月份。实验室结果显示:EV71和CA16是引起2010年海南省HFMD流行的主要病原,但EV71感染在重症病例和死亡病例中占绝对优势。除此之外,还存在部分由其它EV感染引起的HFMD病例。分子流行病学分析提示:2010年海南省流行的EV71均属于C4a亚型,该亚型为我国近年来流行的优势基因型,同时进化分析提示至少存在3条传播链。本研究数据对阐明海南HFMD的流行传播规律,以进一步指导HFMD防控具有重要理论价值。
In order to explore the epidemiological and etiological characteristics of HFMD in Hainan Province in 2010, this study analyzed the reported information of HFMD cases in Hainan Province in 2010, The clinical samples of 1346 HFMD cases in 18 provinces and cities were tested in the enterovirus (EV) laboratory. The positive samples were sequenced and sequenced. The full length genes of VP1 coding region of Enterovirus 71 (EV71) were amplified and sequenced. Bioinformatics software such as Sequencher 5.0 and MEGA 5.0 Molecular epidemiology analysis of EV71 based on VP1 coding region. Epidemiological analysis showed that there were case reports in 18 counties and cities all over the province, especially in the northeastern counties and cities, and at the same time, babies under 4 years of age were high in incidence. However, unlike most provinces in China, the prevalence was at the peak of their onset For September and October. Laboratory results show that: EV71 and CA16 are the major pathogens that caused the epidemic of HFMD in Hainan Province in 2010. However, EV71 infection has the absolute advantage in severe cases and death cases. In addition, there are some cases of HFMD caused by other EV infections. Molecular epidemiological analysis indicated that all the EV71 strains in Hainan Province in 2010 belong to C4a subtypes, which is the dominant genotype prevailing in China in recent years. At the same time, evolutionary analysis suggests that there are at least three transmission chains. The data of this study is of great theoretical value for elucidating the epidemic transmission rules of Hainan HFMD and further guiding the prevention and control of HFMD.