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目的:通过对温州地区引起重症手足口病EV71型的分子流行学研究,监测基因的变异,为科学防治手足口病工作提供依据。方法:对生物标本提取病毒RNA,检测阳性标本进行病毒分离得到毒株,对EV71型VP1片段、全基因组进行测序和分析。结果:临床诊断重症病例核酸检测阳性中,EV71阳性占所有手足口病阳性的比例为81.10%。从中分离到毒株,证实均为EV71 C4亚型。结论:温州全市手足口病疫情的防控形势非常严峻,主要以2周～3周岁儿童为主,5月-7月高发。温州的重症手足口病主要由EV71导致,为C4亚型。重症和死亡病例,可能与EV71病毒5’UTR的空间结构变异有一定的相关性。
Objective: To study the molecular epidemiology of severe hand-foot-mouth disease (EV71) in Wenzhou and to monitor the variation of genes in order to provide a scientific basis for the prevention and control of HFMD. Methods: The viral RNA was extracted from the biological samples, and the positive samples were tested for virus isolation. The EV71 VP1 fragment and whole genome were sequenced and analyzed. Results: In the positive cases of clinical diagnosis of severe cases, EV71 positive accounted for 81.10% of all HFMD cases. Strains were isolated and confirmed to be EV71 C4 subtypes. Conclusion: The situation of prevention and control of HFMD in Wenzhou is very serious. It mainly takes children from 2 weeks to 3 years old and high incidence from May to July. Severe HFMD in Wenzhou is mainly caused by EV71, a subtype of C4. Severe and death cases may be related to the spatial structure variation of 5 ’UTR of EV71 virus.