河北省石家庄市手足口病流行中健康人肠道病毒带毒情况及病原分析

为了解河北省石家庄市健康儿童中肠道病毒带毒情况及血清型构成,对2010~2012年石家庄市的3个县区1 223例0~6岁的健康儿童及406名监护人(健康成人)采集咽拭子和粪便标本进行核酸检测鉴定肠道病毒血清型,并进行分子流行病学分析,为肠道病毒感染相关疾病的防控和治疗提供基础资料。1 223名健康儿童的标本检测结果中,肠道病毒(Enterovirus,EV)阳性的283例,阳性率为23.14%(283/1 223)。其中,以非肠道病毒71型非柯萨奇病毒A组16型的EV(Other-Enterovirus,other-EVs)阳性为主,占EV阳性的62%(175/283),而引起手足口病常见的EV病原体肠道病毒71型(Enterovirus A71,EV71)和柯萨奇病毒A组16型(Coxsackievirus A16,CVA16)阳性率较低,分别占19%(55/283)和18%(51/283);将结果为other-EVs阳性的175名健康儿童的标本全部进行病毒分离鉴定,共分离到25株病毒,分离率为14.29%(25/175),其中柯萨奇病毒B组5型(Coxsackievirus B5,CVB5)分离率最高,为40%(10/25)、柯萨奇病毒B组13型(Coxsackievirus B3,CVB3)分离率为24%(6/25)、埃可病毒21型(Enteric cytopathic human orphan virus 21,ECHO21)分离率为16%(4/25)、其他EV株分离率为20%(5/25)。提示,应加强对CVB3和CVB5等other-EVs的监测。     

肠道病毒B组山东地方株的基因型分布

为明确源自急性弛缓性麻痹(AFP)病例的HEV-B组病毒山东地方株的基因型分布,探讨其优势基因型的变迁与疾病暴发之间的关系,本研究对山东省1994年~2008年AFP监测系统分离到的HEV-B组病毒进行了VP1区核酸扩增和序列测定。序列测定结果显示HEV-B山东地方株共包括29种基因型,其中CVA 1种(CVA9),CVB 5种(CVB1~5),ECHO 20种以及新型肠道病毒EV73、75、97。其中ECHO11、CVB3、ECHO6、ECHO14、ECHO25是AFP监测系统中最常分离到的B组病毒。同源性比较显示,相同血清型HEV-B山东地方株型内核苷酸同源性最小75.4%,最大99.6%,与原型株核苷酸同源性最小73.8%,最大85.2%,但氨基酸变异不大。研究表明,不同基因型病毒具有不同的时间循环模式,相同基因型毒株内部根据其遗传距离的远近又可划分为不同的基因亚型,从而帮助确定HEV的传播途径和传播范围。     

云南省1例疫苗衍生株脊髓灰质炎病毒病例的调查分析

本调查旨在了解2010年云南省昭通市1株脊髓灰质炎Ⅱ型疫苗衍生毒株(Vaccine-derived poliovirus,VDPV)引起的病例的流行病学特征、该病例的排毒情况及其周围健康儿童的肠道病毒(EV)携带情况和病毒型别特征。在该病例的发生地进行现场流行病学调查,连续采集病例粪便标本,采集密切接触者及病例居住地健康儿童粪便标本进行病毒分离和型别鉴定。经省级专家组最终分类诊断为VDPV病例;实验室结果显示病例标本中未再检出VDPV;密切接触者及周围健康儿童标本中均未检测到脊灰疫苗株病毒及VDPV,AFP病例入户主动搜索未发现类似病例,表明该病毒未在当地造成循环;在健康儿童中检测到NPEV 21株,病毒携带率为20.0%;经VP1区核苷酸序列测定,21株NPEV分别属于HEV-A组(11株,3个血清型,占52.4%)和HEV-B组(10株,4个血清型,47.6%)。     

肠道病毒ECHO20血清型鉴定和VP1序列初步分析

肠道病毒(Enterovirus)是最常见的人类致病病毒之一,包括脊髓灰质炎病毒、柯萨奇A组病毒、柯萨奇B组病毒和ECHO病毒.一般认为大多数肠道病毒感染症状轻微或不明显,然而有时肠道病毒感染也可能是严重甚至致命的[1].2004年云南省潞西县局部地区发生小规模的甲肝流行,我们从当地部分患者粪便标本中分离到多株甲肝病毒,同时,经过肠道病毒组合血清和单价血清的中和试验,证明患者为甲肝和ECHO20病毒双重感染.通过文献检索我们发现,国内对ECHO20病毒的相关研究极少,且多限于病毒的血清学分离鉴定,而对其重要的衣壳蛋白编码基因vp1的测定和分析尚未见报道,为阐明ECHO20分离株的分子流行病学特征,分析其基因变异规律,探讨我国分离株和国外分离株的区别和联系,我们测定了编码重要抗原决定簇的整个vp1序列,并和GenBank中已有的ECHO20病毒vp1基因序列进行了比较分析.     

一起传染病暴发中肠道病毒血清型鉴定和ECHO30基因特征分析

2003年5～9月,山东省泰安市发生了由肠道病毒(Enterovirus,EV)感染所致的传染病暴发,临床症状以手足口病(HFMD)为主,同时有心肌炎和无菌性脑膜炎等中枢神经系统症状患者也占较大比例。131份病人(粪便、咽拭子、脑脊液)标本中共分离到EV62株,其中ECHO1939株,EV716株,ECHO304株,其它肠道病毒13株。4株ECHO30病毒中的2株分离自2个患者的粪便标本,但用WHO肠道组合血清中和试验未能定出型别。另外2株分离自同一患者的粪便和脑脊液标本。病原学分析表明,ECHO30是引起该患者无菌性脑膜炎的病原。抗E—CHO30标准株的血清中和这4株病毒的滴度低于标准株5～20倍。VP1区全基因序列测定和同源性比较分析表明,4株ECHO30分离株病毒核苷酸同源性在98．0％～98．5％,氨基酸同源性在98．9％～99．3％,提示这4株病毒来源于同一传播链,2003年5～9月ECHO30在该地区可能有局部流行。系统进化树分析表明,ECHO30病毒可以划分为6个基因型,其中基因型1～5为GenBank中已发表的ECHO30分离株,山东分离株与其它5个基因型成员核苷酸差异分别在9．4％～24．4％,在进化树上形成了较独立的分支,是一个新基因型,将其划分为第6基因型。     

云南省2006～2010年非脊灰肠道病毒分子流行病学特征分析

为了解云南省非脊髓灰质炎(脊灰)肠道病毒(NPEV)的基因型分布及分子进化特征,对2006～2010年间从急性迟缓性麻痹(AFP)病例中分离到的105株NPEVs进行VP1区部分核苷酸扩增和序列测定。所获得的云南地方株基因序列与各基因型原型株进行核苷酸与氨基酸同源性比较,并与GenBank中选取的代表株构建基因进化关系树。结果分析显示:105株NPEVs分别属于HEV-A、HEV-B、HEV-C,其中HEV-A 18株(7个血清型)所占比例为17.1%;HEV-B 77株(22个血清型)所占比例为73.3%,表明云南省AFP病例中流行的NPEV还是以HEV-B为主;HEV-C 10株(4个血清型)所占比例为9.5%;没有分离到HEV-D组肠道病毒;基因进化树中各种血清型病毒与对应原型株及代表株聚集一起,除CA2、EV90和EV76外,云南地方株与原型株位于不同分支。相同型别的毒株在5年的流行过程中变异程度亦不同,亲缘关系远近不一,表明这些病毒在云南省存在不同的传播链。     

肠道病毒ECHO20血清型鉴定和VP1序列初步分析

肠道病毒(Enterovirus)是最常见的人类致病病毒之一,包括脊髓灰质炎病毒、柯萨奇A组病毒、柯萨奇B组病毒和ECHO病毒。一般认为大多数肠道病毒感染症状轻微或不明显,然而有时肠道病毒感染也可能是严重甚至致命的[1]。2004年云南省潞西县局部地区发生小规模的甲肝流行,我们从当地     

肠道病毒ECHO13中国分离株的基因特征

为研究ECHO13病毒中国分离株的分子特征及其与世界其它分离株之间的基因关系,对1998年、2000年从中国福建省分离到2株ECHO13病毒进行基因序列对比分析.2株病毒分别命名为Fujian98-1和Fujian00-1,用逆转录-聚合酶链反应(RT-PCR)扩增出VP1蛋白编码基因全长861个核苷酸片段并进行序列测定,将2株ECHO13病毒的VP1序列与所有已发表的ECHO13病毒VP1基因全长进行同源性比较.结果显示,福建分离株之间核苷酸同源性为79.6%,氨基酸同源性为93.4%;与遗传距离最近的法国CF1089-91(AJ537604)毒株的核苷酸同源性分别为80%和88%,与代表株Del Carmen的核苷酸同源性分别为75.8%和77.9%.通过VP1基因分析,福建2株病毒均属于ECHO13病毒,与血清中和试验鉴定结果一致.下载所有已发表的ECHO13病毒VP1序列并构建进化树,发现福建2株病毒分属不同的分枝,提示这2株病毒来自不同的病毒传播链.进一步分析发现,整个ECHO13病毒可划分为3个不同的基因型:A、B和C基因型.福建Fujian98-1和Fujian00-1分别被划分在基因型B和C中,各基因型之间的核苷酸差异均大于20%.为验证该分型方法,将26株来自不同国家和时间的ECHO13病毒和2株福建分离ECHO13病毒部分VP1基因序列进行对比分析,建立进化树.结果显示,所有ECHO13病毒被分在A、B和C3个基因型中,而2株福建分离病毒仍然被分在B和C基因型中.除了B基因型1株病毒以外,所有3个基因型之间的核苷酸差异均大于15%,与VP1全长分型结果基本一致,说明部分VP1序列的基因分析也能用于对ECHO13病毒进行规律和分子流行病学的研究中.该研究首次报道了ECHO13病毒中国分离株的VP1蛋白基因全长序列,并推荐按VP1基因全长核苷酸差异≥20%作为划分基因型的标准,将已知的ECHO13病毒划分为A、B和C3个基因型.同时也可用病毒VP1基因5′端部分序列替代VP1全长序列来划分基因型.     

2017-2021年宁夏急性驰缓性麻痹病例监测系统非脊灰肠道病毒病原鉴定分析

为了解宁夏急性驰缓性麻痹病例中（acute flaccid paralysis,AFP）非脊灰肠道病毒（non-polio enterovirus,NPEV）的流行,本研究对宁夏2017-2021年急性驰缓性麻痹病例监测中分离到的NPEV进行型别鉴定和基因进化分析。按照监测方案要求采用RD细胞和L20B细胞分离病毒,分离到的病毒进行VP1区的全部核苷酸序列测定、基因型别鉴定分析、系统发生学分析。2017-2021年共收到969份粪便标本,其中AFP病例标本290份,密接者标本679份。从969份标本中共分离到55株NPEV,AFP病例中分离率6.16%(9/146,以例计),密接者人群分离率6.7%(46/679)。其中53株鉴定成功,分别属于人肠道病毒HEV-A、HEV-B、HEV-C组,包含16个血清型别,其中HEV-A组24株（45.2%）,5个血清型,以EV-A71、CVA10、coxsackieviruses (CV)CVA4、为主;HEV-B组28株（54.7%）,10个血清型,以echoviruses(ECHO)30、CVB5、CVB3为主,HEV-C组1株为CVA24,...     

肠道病毒溶瘤作用的研究进展

溶瘤病毒(oncolytic virus,OV)是一类能选择性地在肿瘤细胞中复制并且能够溶解肿瘤细胞,对正常组织细胞无损伤的自然状态或基因改造过的病毒。肠道病毒(enterovirus)是一类单股正链RNA病毒,包括脊髓灰质炎病毒(Poliovirus, PV)、柯萨奇病毒和埃可病毒等。研究证实多种肠道病毒具有溶瘤作用,如已在拉脱维亚等国上市的RIGVIR~?(埃可病毒7型,Echovirus 7, ECHO7),已进入Ⅱ期临床试验的柯萨奇病毒A组21型(Coxsackievirus A21, CVA21),以及处于临床前研究阶段的柯萨奇病毒B组3型(Coxsackievirus B3, CVB3)及PV等。现就有关肠道病毒的溶瘤作用作一概述。     

2010年7～12月肠道病毒B组河南株的血清学分布

本文对河南省2010年7~12月的HFMD监测标本进行了肠道病毒B组的血清型分布研究。来自HFMD病例的阳性病毒分离物进行分子分型方法鉴定并进行VP1完整编码区核苷酸序列测定和分析。所获VP1全序与其他B组各基因型代表株和中国大陆株进行比较并构建系统发生树。共获得14株HEV-B河南株,分为E1、E6 、E11、 E13、 E25、 E30共6个血清型。VP1系统进化分析显示2010年河南HEV-B分离株与原型株亲缘关系较远,E25、E11和E6均与山东株亲缘关系最近,E1和E13均与云南株亲缘关系最近,E30与2008年河南株亲缘关系最近。E6病毒存在两种基因型的共循环现象。     

Evidence for frequent recombination within species human enterovirus B based on complete genomic sequences of all thirty-seven serotypes

The species Human enterovirus B (HEV-B) in the family Picornaviridae consists of coxsackievirus A9; coxsackieviruses B1 to B6; echoviruses 1 to 7, 9, 11 to 21, 24 to 27, and 29 to 33; and enteroviruses 69 and 73. We have determined complete genome sequences for the remaining 22 HEV-B serotypes whose sequences were not represented in public databases and analyzed these in conjunction with previously available complete sequences in GenBank. Members of HEV-B were monophyletic relative to all other human enterovirus species in all regions of the genome except in the 5'-nontranslated region (NTR), where they are known to cluster with members of HEV-A. Within HEV-B, phylogenies constructed from the structural (P1) and nonstructural regions of the genome (P2 and P3) are incongruent, suggesting that recombination had occurred. Similarity plots and bootscanning analysis across the complete genome identified multiple sites at which the phylogeny of a given strain's sequence shifted, indicating potential recombination points. These points are distributed in the 5'-NTR and throughout P2 and P3, but no sites with >80% bootstrap support were identified within the capsid. Individual sequence comparisons and phylogenetic analyses suggest that members of HEV-B have recombined with one another on multiple occasions, resulting in a complex mosaic of sequences derived from multiple parental viruses in the nonstructural regions of the genome. We conclude that RNA recombination is a common mechanism for enterovirus evolution and that recombination within the nonstructural regions of the genome (P2 and P3) has been observed only among members of the same species.     

Epidemics and Frequent Recombination within Species in Outbreaks of Human Enterovirus B-Associated Hand,Foot and Mouth Disease in Shandong China in 2010 and 2011

The epidemiology and molecular characteristics of human enterovirus B (HEV-B) associated with hand, foot and mouth disease (HFMD) outbreaks in China are not well known. In the present study, we tested 201 HEV isolates from 233 clinical specimens from patients with severe HFMD during 2010–2011 in Linyi, Shandong, China. Of the 201 isolates, 189 were fully typed and 18 corresponded to HEV-B species (six serotypes CVA9, CVB1, CVB4, Echo 6, Echo 25 and Echo 30) using sensitive semi-nested polymerase chain reaction analysis of VP1 gene sequences. Phylogenetic analysis based on the VP1 region showed that eight E30SD belonged to a novel sub-genogroup D2; E25SD belonged to a novel sub-genogroup D6; E6SD belonged to sub-lineage C6 and five CVB1SD belonged to subgroup 4C; and B4SD belonged sub-lineage D2. The full viral genomes of the CVB1SD, E6SD, E25SD and E30SD isolates were sequenced. Analysis of phylogenetic and similarity plots indicated that E25SD recombined with E25-HN-2, E30FDJS03 and E4AUS250 at noncontiguous P2A–P3D regions, while E30SD, E30FDJ03, E25-HN-2 and E9 DM had shared sequences in discrete regions of P2 and P3. Both E6SD and B1SD shared sequences with E1-HN, B4/GX/10, B5-HN, and A9-Alberta in contiguous regions of most of P2 and P3. Genetic algorithm recombination detection analysis further confirmed the existence of multiple potential recombination points. In conclusion, analysis of the complete genomes of E25SD, E30SD, CVB1SD and E6SD isolated from HFMD patients revealed that they formed novel subgenogroup. Given the prevalence and recombination of these viruses in outbreaks of HFMD, persistent surveillance of HFMD-associated HEV-B pathogens is required to predict potential emerging viruses and related disease outbreaks.     

A retrospective overview of enterovirus infection diagnosis and molecular epidemiology in the public hospitals of Marseille, France (1985-2005)

Human enteroviruses (HEV) are frequent human pathogens and, associated in particular with large outbreaks of aseptic meningitis. Here, we have compiled a database of clinical HEV isolates from the Public Hospitals of Marseille, from 1985 to 2005. Amongst 654 isolates that could be characterized by complete sequencing of the VP1 gene, 98% belonged to species HEV-B; the most frequently isolated serotypes were Echovirus E30, E11, E7, E6 and E4. The high incidence of E30 and the recent emergence of E13 are consistent with reports worldwide and peak HEV isolation occurred mostly in the late spring and summer months. The proportion of echoviruses has decreased across the years, while that of coxsackieviruses has increased. Stool (the most frequent sample type) allowed detection of all identified serotypes. MRC5 (Human lung fibroblasts) cell line was the most conducive cell line for HEV isolation (84.9% of 10 most common serotype isolates, 96.3% in association with BGM (Buffalo green monkey kidney cells)). Previous seroneutralization-based serotype identification demonstrated 55.4% accuracy when compared with molecular VP1 analysis. Our analysis of a large number of clinical strains over 20 years reinforced the validity of VP1 serotyping and showed that comparative p-distance scores can be coupled with phylogenetic analysis to provide non-ambiguous serotype identification. Phylogenetic analysis in the VP1, 2C and 3D regions also provided evidence for recombination events amongst clinical isolates. In particular, it identified isolates with dissimilar VP1 but almost identical nonstructural regions.     

1996年延边地区无菌性脑膜脑炎病因病毒的分离及初步鉴定

吉林省延边地区１９９６年６月发生无菌性脑膜脑炎流行,在全地区２１６万人口中,发病人数约５￣６千人,死亡２人,为历史上所罕见。从病人脑脊液和粪便标本中分离到多株病毒,分离率较高（分别达到５２．４％￣６６．７％）。用ＷＨＯ提供的ＲＩＶＭ肠道病毒组合血清进行中和定型,不能确定型别。ＲＴ－ＰＣＲ结果表明为肠道病毒。病人早期血清特异性ＩｇＭ抗性阳性率７２．０％,证明所分离的病毒为此次无菌性脑膜脑炎暴发流行的     

Prevalence of infection with nonpolio enteroviruses among healthy children from a children's home and in a summer camp

The sera obtained at 6 samplings between June 1981 and May 1982 from 30 children in a children's home were tested for neutralizing antibodies to coxsackieviruses B1 through B5, echovirus serotypes 1, 2, 4, 5, 6, 7, 11, 19, 24, 30 and to enterovirus type 71. Another group of examined children comprised 19 individuals from the children's home and 63 children from families who enrolled as participants of a summer camp recreation. Samples of their sera were obtained at the beginning and the end of camping in July and August of 1981. Virus isolations were attempted in 150 stool specimens collected at various times during the observation period, and in specimens of summer camp swimming pool water collected 2-3 times a week. Overall, 10 strains of enterovirus (CB2, E2, E19, E24) were isolated from stool, but none from swimming pool water. Serologically, fourfold or greater increases in titre of antibody to at least one of the enteroviruses tested were observed 17 children, of whom 4 children showed antibody titre increases simultaneously to two enterovirus serotypes. None of the present viruses showed a tendency to mass spread. Some of the examined children showed the presence of serum antibody to enterovirus before its isolation from stool. Eight of the ten children positive for enterovirus in stool did not react by significant increases in titre of antibodies. Enteroviruses were more frequently isolated in children's home in autumn than in summer camp. Clinically, all virologically or serologically demonstrated enteroviral infections were asymptomatic. Children's home children had a significantly higher prevalence of antibodies to enteroviruses than children from families. Presumably, asymptomatic infections with nonpolio enteroviruses among children appear to be far more frequent than the results of neutralization tests in the study indicated. Moreover, enteroviruses may apparently circulate among humans who are seropositive for the respective enterovirus serotype.     

Enteroviral aseptic meningitis in Japan, 1981-1991. A report of the National Epidemiological Surveillance of Infectious Agents in Japan.

In Japan, aseptic meningitis cases due to enterovirus infections increase every summer in various degrees with an incidence peak usually in July. During the past 11 years from 1981 through 1991, a total of 8,595 enterovirus isolations from aseptic meningitis cases were reported from 54 participating laboratories. Eight enterovirus types caused large epidemics; more than 100 isolations of each type from aseptic meningitis cases were reported for every epidemic year of the respective type. They were coxsackievirus (C) types B3 and B5, echovirus (E) types 4, 6, 7, 9, 18 and 30. Among these, the highest meningitis-associating frequency was reported for E30, representing 82.6% of the total isolations reported for the type during this period, followed by E4, 71.1%. The frequencies of E9, E7, E6 and CB5 were in a range from 54.5% to 44.4%, while that of E18 was 37.7% and that of CB3 21.0%. During the epidemics, enterovirus-associated meningitis was most frequently reported among children of 4-7 years of age. High frequencies were also shown in infants less than 1-year of age in some types. A total of 4,240 enteroviruses were isolated from cerebrospinal fluid of aseptic meningitis cases, representing 49.3% of the cases with enterovirus isolation.