| Hand, foot and mouth disease(Hand-foot –mouth diseases, HFMD) is a common infectious disease caused by different kinds of intestinal virus, give priority to with infant disease. Began in March 2008 in fuyang city in Anhui province in China popular hand, foot and mouth disease pathogens, lab tests by the Chinese center for disease control and prevention, the results confirmed to be caused by EV71, ministry of health in May 2008, foot and mouth disease into the c class infectious diseases. After years of hand, foot and mouth disease situation is still grim, Bo Zhou city, as the serious outbreak of fuyang city adjacent to, what about the city′s hand-foot- mouth disease pathogens prevalence and enterovirus 71 type molecular epidemiological? This topic is of Bo Zhou city, hand-foot-mouth disease pathogens and the situation of enterovirus type 71 molecular classification and evolution are studied, to serve the needs of clinical diagnosis and treatment and epidemiological studies, more effective for the laboratory diagnosis and monitoring of HFMD.Objective:In May 2012 to April 2013, suspected of children with hand, foot and mouth disease in hospital pharyngeal swab viral RNA extraction method, application of real-time fluorescent RT-PCR technique to detect pathogens category, collect related medical records, and take statistics of EV71 infection and polymerase chain reaction technology and bioinformatics method of EV71 VP1 fragments were analyzed, and the research of the city′s hand, foot and mouth disease epidemiology characteristics, EV71 infection EV71 clinical characteristics and genotyping and molecular evolution situation, for the diagnosis and treatment of HFMD, provide reliable scientific basis for prevention and monitoring.Result:1. 1175 cases of hospitalized patients with suspected disease(HFMD) throat swab specimens of 782 cases of male, female 393 cases, 562 cases were detected the intestinal virus positive patients. No statistically significant differences between different gender intestinal virus(χ2 = 3.434, P = 3.434), EV71 infection between different gender and the differences of other enterovirus was statistically significant(χ2 = 4.765, P = 4.765). No significant difference of the intestinal infection among different age groups(2=1.603, P=0.449), but for the enterovirus infected patients in different age groups of EV71 infection and other enterovirus infection was statistically significant(2=8.422, P=0.015). In 196 cases of EV71 infection cases, 124 cases of male, female 72 cases, male to female ratio is 1.72:1, age range for 4 months to 6 years old, the average age of 1.8 years, including 96 people in the 0 ~ 1 years old age of patients, 88 patients at the age of 1 ~ 3 years old, 3 patients over the age of 12, EV71 infection is given priority to with children under the age of 3, 93.9% of the patients with EV71 feeling; In 6 cases of Cox-A16 infection cases, 5 cases were male, female in 1 case, ratio of 5:1, age range is 1 ~ 4 years old, the average age of 1.68 years, including 4 month ~ 1 years old age of patients, 2 ~ 3 years old age of patients, 3 patients over the age of 1 person, Cox-A16 infection is given priority to with children under the age of 3, 83.3%; 360 cases of other enterovirus infection, male 260 cases, 100 cases of female, male to female ratio is 2.6:1, the age range of 1 ~ 9 years old, the average age of 1.58 years, including 222 people in the 0 ~ 1 years old age of patients, 123 patients with 2 ~ 3 years old, 3 patients over the age of 15 people, other enterovirus infection is given priority to with children under the age of 3, 95.8%. Enterovirus infections in each month of the difference was statistically significant(χ2 = 72.324, P < 0.05), presenting with multiple trend in spring and summer. In different months and other enterovirus infections difference was statistically significant(χ2 = 42.992, P < 0.05). In 196 cases of EV71 infection of distribution is given priority to with the onset of spring and summer, in April for the rush hour. The age distribution of three patients with no statistically significant differences in type(χ2 = 1.038, P = 1.038), different clinical classification EV71 infections in each month therewas no statistically significant difference of distribution(χ2 = 18.479, P = 18.479).2. 6 strains from different disease degree of sample was sequenced, 6 strains of EV71 VP1 gene nucleotide similarity between 96.0% ~ 99.7%, the similarity is 94.6% ~ 100% amino acid, the source of different disease degree of EV71 VP1 gene found no specific nucleotide mutations. System evolution in the trees, there are multiple chain of transmission, and representative C4 a subtype strains in the same branch, nucleotide similarity is 96.0% ~ 98.6%, amino acid similarity was 98.0 ~ 99.6%.Conclusion:1. In May 2012 to April 2013, Bo Zhou city, 1175 cases hospitalized patients of suspected HFMD pharyngeal swab specimens inspection have tested positive for enterovirus 562 cases of patients, the communist party of China in a non Cox-A16-enteroviruses EV71 infection.2. In May 2012 to April 2012, Bo Zhou city,hand-foot-mouth disease enterovirus infection in age, don′t wait there is no statistical difference of population distribution characteristics; Intestinal virus nucleic acid positive people different kinds of enterovirus infection was statistically differences in sex and age, different gender and age groups are susceptible to other enterovirus infections.3. In May 2012 to April 2012, Bo Zhou city, hand-foot-mouth disease is concentrated in April- June, presenting multiple trend in spring and summer. The non Cox-A16- enteroviruses EV71 is the main pathogen of during the study period.4. In May 2012 to April 2013, EV71 is main pathogens in patients with critical and serious syndrome. The other enteroviruses and Cox-A16 is given priority to with normal cases.5. In May 2012 to April 2013, EV71 epidemic strains of subtype C4 a,there are multiple EV71 chain of transmission in Bo Zhou city. EV71 of Bo Zhou city and the surrounding provinces and cities of epidemic strains for the same evolutionary branches.6. In May 2012 to April 2013, EV71 infections disease classification differentnucleotide and amino acid variation is similar in Bo Zhou city..6, In May 2012 to April 2012, regional differences, the strain of nucleotide and amino acid variation is similar. |
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