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目的了解河北省2011-2014年手足口病病原以及其他(非EV71及非CoxA16的肠道病毒)肠道病毒分子遗传进化特征。方法利用描述流行病学方法对河北省2011-2014年疾病监测信息报告系统上报的手足口病病例资料和实验室检测结果进行统计分析,利用DNAstar软件包和MEGA软件分析其他肠道病毒的基因进化特征。结果手足口病病原检测病原构成以EV71为主,阳性率为53.49%,且不同年份病原构成略有不同。在轻症病例中,2012年CoxA16构成比为44.56%,2013年其他肠道病毒构成比为48.54%,但仍有>75%的重症病例和85%的死亡病例由EV71感染引起。CVA6、CVA10、CVA4肠道病毒的分离株与其相应原型株的VP1区核苷酸序列差异均较大,但各型分离株具有较高的内部序列同源性,在进化树上与深圳、上海等相应分离株共进化共循环。结论 EV71是本地区手足口病的主要病原体,但EV71和CVA16感染所占比例总体上呈下降趋势,其他肠道病毒所占比例总体上呈缓慢上升的趋势,加强非EV71、非CoxA16肠道病毒的检测和鉴定分型将有助于手足口病预防和控制。
Objective To understand the molecular genetic evolution of HFMD in Hebei province during 2011-2014 and other enterovirus (non-EV71 and non-CoxA16 enterovirus). Methods Descriptive epidemiological methods were used to analyze the data of cases of HFMD reported by the Disease Surveillance Information Reporting System in Hebei Province from 2011 to 2014 and the laboratory test results. The DNAstar software package and MEGA software were used to analyze the genetic evolution of other enteroviruses feature. Results The pathogens of HFMD were EV71, the positive rate was 53.49%, and the pathogen composition was slightly different in different years. In mild cases, the CoxA16 ratio was 44.56% in 2012 and 48.54% in 2013. However, there were still> 75% of severe cases and 85% of deaths from EV71 infection. The nucleotide sequences of VP1 of CVA6, CVA10 and CVA4 enterovirus isolates were all different from that of the corresponding prototype strains, but all the isolates had high internal sequence homology. The corresponding isolates co-evolution and co-cycle. Conclusions EV71 is the major pathogen of hand-foot-mouth disease in this area. However, the proportion of EV71 and CVA16 infection is generally on the downward trend. The proportion of other enteroviruses tends to increase slowly as a whole. EV71, non-CoxA16 enterovirus The detection and identification of typing will help hand foot and mouth disease prevention and control.