孔志芳, 倪红霞, 杨斌, 谢蕾, 张丹, 王晓英, 章海斌, 胡莉莉, 葛宝湘, 陈伟, 王帆. 2018年浙江省宁海县柯萨奇病毒A组6型手足口病临床特征及分子流行病学[J]. 疾病监测, 2019, 34(11): 1005-1009. DOI: 10.3784/j.issn.1003-9961.2019.11.012
引用本文: 孔志芳, 倪红霞, 杨斌, 谢蕾, 张丹, 王晓英, 章海斌, 胡莉莉, 葛宝湘, 陈伟, 王帆. 2018年浙江省宁海县柯萨奇病毒A组6型手足口病临床特征及分子流行病学[J]. 疾病监测, 2019, 34(11): 1005-1009. DOI: 10.3784/j.issn.1003-9961.2019.11.012
Zhifang Kong, Hongxia Ni, Bin Yang, Lei Xie, Dan Zhang, Xiaoying Wang, Haibin Zhang, Lili Hu, Baoxiang Ge, Wei Chen, Fan Wang. Clinical and molecular epidemiological characteristics of hand foot and mouth disease caused by Coxsackievirus A6 in Ninghai, Zhejiang, 2018[J]. Disease Surveillance, 2019, 34(11): 1005-1009. DOI: 10.3784/j.issn.1003-9961.2019.11.012
Citation: Zhifang Kong, Hongxia Ni, Bin Yang, Lei Xie, Dan Zhang, Xiaoying Wang, Haibin Zhang, Lili Hu, Baoxiang Ge, Wei Chen, Fan Wang. Clinical and molecular epidemiological characteristics of hand foot and mouth disease caused by Coxsackievirus A6 in Ninghai, Zhejiang, 2018[J]. Disease Surveillance, 2019, 34(11): 1005-1009. DOI: 10.3784/j.issn.1003-9961.2019.11.012

2018年浙江省宁海县柯萨奇病毒A组6型手足口病临床特征及分子流行病学

Clinical and molecular epidemiological characteristics of hand foot and mouth disease caused by Coxsackievirus A6 in Ninghai, Zhejiang, 2018

  • 摘要:
    目的了解浙江省宁海县柯萨奇病毒A组6型(Cox A6)手足口病的临床特征,探讨其防控策略和措施。
    方法从国家疾病监测信息系统获取2018年宁海县手足口病资料,采集宁海县第一医院手足口病门诊、住院患者粪便和(或)咽拭子标本,用实时荧光定量反转录–聚合酶链式反应(RT-PCR)方法检测肠道病毒通用型及核酸分型,对Cox A6阳性标本进一步用RT-PCR方法进行VP1全长基因扩增、测序和系统进化分析。
    结果肠道病毒核酸阳性635例,阳性率为75.42%,其中Cox A6、非Cox A6阳性分别为412例(64.88%)和223(35.12%);对Cox A6与非Cox A6病例组的临床表现进行比较,年龄、发热及热程、皮疹分布范围、出现疱疹及大疱疹比例、皮肤疼痛和痒感、脱皮及色素沉着、随访16周脱甲率等因素差异有统计学意义。 序列分析显示,2018年宁海县流行的Cox A6均为D3基因亚群,D3.2分枝。
    结论2018年宁海县Cox A6 D3基因亚群病毒广泛流行,临床上表现为皮肤黏膜剧烈反应,皮疹分布较非Cox A6广泛,脱甲为Cox A6病毒对指(趾)甲的直接侵害。

     

    Abstract:
    ObjectiveTo understand the clinical characteristics of hand foot and mouth disease (HFMD) caused by Coxsackievirus A6 (Cox A6) in Ninghai county of Zhejiang province and discuss its prevention and control strategies and measures.
    MethodsThe information about HFMD in Ninghai in 2018 were obtained from the National Disease Surveillance Information System, and the stool samples and/or pharynx swabs were collected from the outpatients and inpatients of HFMD in the First Hospital of Ninghai for the detection of enteroviruses and nucleic acid typing by fluorescence RT-PCR. VP1 total length gene amplification, sequencing and phylogenetic analysis of Cox A6 positive samples were further studied by RT-PCR.
    ResultsA total of 635 cases were enterovirus nucleic acid positive, the positive rate was 75.42%, among them, 412 were CV-A6 positive (64.88 %) and 223 were non-Cox A6 positive (35.12 %). The clinical manifestations of Cox A6 positive cases and non-Cox A6 positive cases were compared. There were significant differences in age, fever and heat range, distribution of rash, incidence of herpes and large herpes, skin pain and itching, desquamation and pigmentation, as well as nail separation rate in 16 weeks follow-up between Cox A6 positive cases and non-Cox A6 positive cases. Sequence analysis showed that the Cox A6 viruses detected in Ninghai in 2018 belonged to D3 gene subgroups and D3.2 clade.
    ConclusionIn 2018, Cox A6 virus D3 gene subgroup spread in Ninghai, the infection cases were clinically characterized by fever and herpes pharyngitis, followed by severe skin mucosa reaction. The rash was distributed more widely in Cox A6 cases than in non-Cox A6 cases. Nail separation was mainly caused by the attack of Cox A6.

     

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