The etiological and epidemiological characteristics of herpangina cases in Shenzhen City, 2015
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摘要: 目的 分析2015年监测的深圳地区疱疹性咽峡炎的病原学情况和流行病学特征,为疱疹性咽峡炎的预防和控制提供数据基础。方法 2015年共收集深圳地区70例疱疹性咽峡炎病例粪标本,采用荧光定量RT-PCR(real time PCR,RT-PCR)和RT-snPCR(real time transcription-seminested PCR,RT-snPCR)法对样本进行肠道病毒(enterovirus,EV)检测,并对主要的流行株进行基因亚型的鉴别和系统进化分析。结果 在70例疱疹性咽峡炎患者中,EV阳性率为88.57%;阳性结果中共检测出6种病毒,其中,柯萨奇病毒A6(coxsackie virus A6,CA6)和柯萨奇病毒A2(coxsackie virus A2,CA2)的阳性标本最多,分别为22例和16例,且分别占总发病病例数的31.43%和22.86%;基于核酸序列的VP1区构建的系统进化树显示,CA6毒株的基因亚型均为B型,核苷酸和氨基酸同源性分别为96.2%~100%和97.3%~100%。CA2与香港地区CA2流行株的序列高度同源,其核苷酸同源性为91.1%~99.6%,氨基酸同源性为92.4%~100%。结论 2015年深圳地区流行的病原均属于A组肠道病毒,其中B型CA6 是引起疱疹性咽峡炎的主要流行病毒株。Abstract: Objective To analyze the etiological and epidemic characteristics of herpangina (HA) monitored in Shenzhen City in 2015, and to provide laboratory data for the epidemic control. Methods Seventy herpangina samples were collected in Shenzhen city in 2015. RT-PCR and RT-snPCR assays were performed to detect HEVs-postive specimens. Phylogenetic tree was contructed to identify the genotype of the predominant epidemic isolates. And the nucleotide sequence homology was analyzed among Shenzhen viral sequences and others viral sequences published in GenBank. Results According to the laboratory test results, 62 cases were enterovirus positive and the positive rate was 88.57%. Among these positive cases, six serotypes of EV including CA6, CA2, CA10, EV71, CA16 and CA5 were detected. CA6 and CA2 were the predominant serotype. A total of 22 and 16 cases of herpangina were infected by CA6 and CA2 which accouted for 31.43% and 22.86% of the totcucases respectively. Phylogenetic analysis showed that all CA6 strains determined in this study were belonged to B subgenotype. The nucleotide sequences identities of the VP1 gene among CA6 strains were 96.2%-100%. The homology of amino acid of the VP1 gene among CA6 strains was 97.3%-100%. The VP1 sequences of Shenzhen CA2 isolates shared high similarity with those of Hong Kong isolates. And their homologies of nucleotide and amino acid sequences were 91.1%-99.6% and 92.4%-100%, respectively. Conclusions A total of six different serotypes were detected in this study in which all six serotypes belonged to HEV-A species. And subgenotype B virus of CA6 may play an important role in the development of herpangina and it was the predominant etiologic agent of herpangina cases in this study.
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Key words:
- Herpangina /
- Enterovirus A, human /
- Coxsackievirus infections
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Sano T, Saito T, Kondo M, et al. Enterovirus detection status of patients with herpangina and hand, foot and mouth disease in epidemic season 2007, Kanagawa Prefecture, Japan [J]. Jpn J Infect Dis, 2008,61(2):162-163. Chen KT, Chang HL, Wang ST, et al. Epidemiologic features of hand-foot-mouth disease and herpangina caused by enterovirus 71 in Taiwan, 1998-2005 [J]. Pediatrics, 2007,120(2):e244-252. Puenpa J, Mauleekoonphairoj J, Linsuwanon P, et al. Prevalence and characterization of enterovirus infections among pediatric patients with hand foot mouth disease, herpangina and influenza like illness in Thailand, 2012 [J]. PLoS One, 2014,9(6):e98888. Chen YH, Lin HC, Lin HC. Increased risk of adverse pregnancy outcomes among women affected by herpangina [J]. Am J Obstet Gynecol, 2010,203(1):49.e1-7. Solomon T, Lewthwaite P, Perera D, et al. Virology, epidemiology, pathogenesis, and control of enterovirus 71 [J]. Lancet Infect Dis, 2010,10(11):778-790. Shah VA, Chong CY, Chan KP, et al. Clinical characteristics of an outbreak of hand, foot and mouth disease in Singapore [J]. Ann Acad Med Singapore, 2003, 32(3):381-387. Chang LY, King CC, Hsu KH, et al. Risk factors of enterovirus 71 infection and associated hand, foot, and mouth disease/herpangina in children during an epidemic in Taiwan [J]. Pediatrics, 2002,109(6):e88. 蔡春林,姚相杰,卓菲,等. 深圳地区疱疹性咽峡炎疫情的柯萨奇病毒A4型VP1区基因特征分析 [J]. 中华医学杂志, 2015,95(16):1226-1229. Mirand A, Schuffenecker I, Henquell C, et al. Phylogenetic evidence for a recent spread of two populations of human enterovirus 71 in European countries [J]. J Gen Virol, 2010,91(Pt 9):2263-2277. Nix WA, Oberste MS, Pallansch MA. Sensitive, seminested PCR amplification of VP1 sequences for direct identification of all enterovirus serotypes from original clinical specimens [J]. J Clin Microbiol, 2006,44(8):2698-2704. Yip CC, Lau SK, Woo PC, et al. Recombinant coxsackievirus A2 and deaths of children, Hong Kong, 2012 [J]. Emerg Infect Dis, 2013,19(8):1285-1288. Chen SP, Huang YC, Li WC, et al. Comparison of clinical features between coxsackievirus A2 and enterovirus 71 during the enterovirus outbreak in Taiwan, 2008: a children's hospital experience [J]. J Microbiol Immunol Infect, 2010, 43(2):99-104. 李佳萌,李琳,吕莉琨,等. 2014年天津市肠道病毒所致疱疹性咽峡炎临床流行病学分析 [J]. 中华疾病控制杂志, 2016,20(1):26-29. 王宏宇,张小爱,许红梅,等. 手足口病患者不同标本中肠道病毒检测结果比较 [J]. 中华疾病控制杂志, 2014,18(6):501-503. Crawford NW, Graham SM. EV71 vaccine: protection from a previously neglected disease [J]. Lancet, 2013,381(9882):1968-1970. Miyazawa I, Azegami Y, Kasuo S, et al. Prevalence of enterovirus from patients with herpangina and hand, foot and mouth disease in Nagano Prefecture, Japan, 2007 [J]. Jpn J Infect Dis, 2008,61(3):247-248. Mirand A, Henquell C, Archimbaud C, et al. Outbreak of hand, foot and mouth disease/herpangina associated with coxsackievirus A6 and A10 infections in 2010, France: a large citywide, prospective observational study [J]. Clin Microbiol Infect, 2012,18(5):E110-E118. El Houmami N, Minodier P, Dubourg G, et al. An outbreak of Kingella kingae infections associated with hand, foot and mouth disease/herpangina virus outbreak in Marseille, France, 2013 [J]. Pediatr Infect Dis J, 2015,34(3):246-250. Yamashita T, Ito M, Taniguchi A, et al. Prevalence of coxsackievirus A5, A6, and A10 in patients with herpangina in Aichi Prefecture, 2005 [J]. Jpn J Infect Dis, 2005,58(6):390-391. Bracho MA, González-Candelas F, Valero A, et al. Enterovirus co-infections and onychomadesis after hand, foot, and mouth disease, Spain, 2008 [J]. Emerg Infect Dis, 2011,17(12):2223-2231. Huang Y, Zhou Y, Lu H, et al. Characterization of severe hand, foot, and mouth disease in Shenzhen, China, 2009-2013 [J]. J Med Virol, 2015,87(9):1471-1479.
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