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目的手足口病是2~5岁儿童常见的感染性疾病,近年来在亚太地区多次爆发流行,死亡率较高,本研究的目的是分析2008年广州地区爆发流行的手足口病的病毒分子流行病学及其与气象变量之间的关系。方法从互联网收集气象资料,收集466例疑似手足口病患儿的咽拭子标本,扩增人肠道病毒5′端非编码区,PCR产物测序并在Genbank中BLAST分析,分析肠道病毒基因型。结果成功从临床咽拭子标本中扩增了5′-NCR用于基因分型。从466例临床标本中扩增出165例阳性标本,获得12种肠道病毒类型:77例(46.67%)EV-71,37例(22.42%)CVA16,31例(18.79%)CV-A4,20例其它型别。EV-71和CV-A16是本次流行的主要病原。手足口病总发病率与CVA16和EV-71显著相关。手足口病发病率与疾病症状出现前7天的最高气温(P=0.00)、平均温度(P=0.001)和平均湿度(P=0.017)显著相关。结论 5’-NCR测序是手足口病病原体基因分型和监测的敏感、简单、早期、快速的检测方法,EV-71和CV-A16是本次手足口病爆发的重要肠道病毒。气象变量包括最高温度、平均气温、相对湿度明显与手足口病发病率相关,在时间上滞后一周,这可作为手足口病暴发监测的潜在指标指导卫生决策。
Purpose Hand-foot-mouth disease is a common infectious disease in children aged 2 to 5 years. In recent years, it has been endemic to the Asia-Pacific region with many deaths. The purpose of this study was to analyze the molecular patterns of HFMD in Guangzhou in 2008 Epidemiology and its relationship with meteorological variables. Methods Meteorological data were collected from the Internet. Throat swab samples from 466 suspected HFMD patients were collected and the 5 ’non-coding region of human enterovirus was amplified. The PCR products were sequenced and analyzed by BLAST in Genbank. type. Results The 5’-NCR was successfully amplified from clinical throat swab specimens for genotyping. A total of 165 positive samples were amplified from 466 clinical samples and 12 types of enterovirus were obtained: 77 (46.67%) EV-71, 37 (22.42%) CVA16 and 31 (18.79%) CV- 20 cases of other types. EV-71 and CV-A16 are the major pathogens of this epidemic. The overall incidence of hand-foot-mouth disease was significantly associated with CVA16 and EV-71. The incidence of hand-foot-mouth disease was significantly associated with the highest temperature (P = 0.00), mean temperature (P = 0.001) and mean humidity (P = 0.017) 7 days before symptom onset. Conclusion 5’-NCR sequencing is a sensitive, simple, rapid and early detection method for the pathogenesis of HFMD. EV-71 and CV-A16 are important enterovirus in HFMD. Meteorological variables including maximum temperature, mean temperature, and relative humidity were significantly associated with HFMD incidence and lagged by a week in time, which could be used as a potential indicator of HFMO monitoring to guide health decisions.