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为了解2023年河南省急性弛缓性麻痹（Acute flaccid paralysis,AFP）病例中非脊髓灰质炎肠道病毒（Nonpolio enterovirus,NPEV）的病原学及流行病学特征，为AFP的防控以及治疗提供理论支持。本研究采集2023年报告的AFP病例双份粪便标本进行病毒分离培养，对检出的NPEV毒株VP1区进行核苷酸序列测定和分析，使用mafft v7.526和MEGA 5.1软件对序列进行比对和遗传进化分析。使用SPSS 26软件对数据进行统计分析。结果显示2023年河南省报告706例AFP病例，报告发病率为3.13/10万，共检出25株NPEV，检出率为3.54%(25/706），其中20株为A组肠道病毒（Enterovirus A,EV-A），占比为80%,5株为B组肠道病毒（Enterovirus B,EV-B），占比为20.00%，未检出C组和D组肠道病毒。EV-A中共有6个血清型，其中柯萨奇病毒A4(Coxsackievirus,CVA4）检出数最多（均为C基因型），检出率为35.00%(7/20），其次为CVA10（均为C基因型），检出率为30.00%(6/20),EV-B均为CVB2（均为D基因型），三种血清型均与手足口病例中检出的的毒株关系较近。不同人群之中，3～5岁组AFP病例报告率最高，为30.45%(215/706),0～2岁组中NPEV检出率最高，为5.46%(10/183），男女发病数比为1.37:1，不同性别之间NPEV检出率差异无统计学意义（P>0.05）。在地区分布上，EV-A分布最为广泛，其中CVA4主要分布在豫北、豫中和豫西，CVA10主要分布在豫北、豫中和豫南，EV-B主要分布在豫东和豫南。在时间分布上，夏秋两季检出率较高，冬春季检出率相对较低，其中EV-A呈现双峰，最高峰出现在10月份，EV-B主要发生在6-8月份。以上结果表明，2023年河南省分离的NPEV以EV-A中的CVA4和CVA10为主要血清型，且分布最为广泛，相比往年以EV-B为主要血清型发生了显著变化，后期应继续对NPEV进行监测，为NPEV可能引起的疾病的暴发流行预测预警提供基线数据。
Abstract：To investigate the etiological and epidemiological characteristics of non-polio enteroviruses (NPEVs) in acute flaccid paralysis (AFP) cases reported in Henan Province,China in 2023,and to provide theoretical support for the prevention,control,and treatment of AFP,duplicate stool specimens were collected from reported AFP cases for virus isolation and culture.The VP1 region of isolated NPEV strain was sequenced and subjected to nucleotide analysis.Sequence alignment and phylogenetic analysis were conducted using MAFFT v7.526 and MEGA 5.1,and statistical analyses were performed using SPSS 26.A total of 706 AFP cases were reported in Henan Province in 2023,with an incidence rate of 3.13 per 100,000.Twenty-five NPEV strains were isolated,yielding a detection rate of 3.54%(25/706).Among them,20 strains (80%) were identified as Enterovirus A (EV-A),and 5 strains (20%) as Enterovirus B (EV-B);no strains from Enterovirus C or D groups were detected.Six serotypes were identified within EV-A,with Coxsackievirus A4 (CVA4,all genotype C) being the most prevalent,accounting for 35.00%(7/20),followed by CVA10 (all genotype C),accounting for 30.00%(6/20).All EV-B isolates were Coxsackievirus B2 (CVB2,all genotype D).The three detected serotypes showed close phylogenetic relationships to strains previously isolated from hand,foot,and mouth disease (HFMD) cases.Among different age groups,the highest AFP incidence was observed in children aged 3～5 years (30.45%,215/706),while the highest NPEV detection rate occurred in the 0～2 year age group (5.46%,10/183).The male-to-female ratio of reported cases was 1.37:1,with no statistically significant difference in NPEV detection rates between sexes (P>0.05).Geographically,EV-A strains were more widely distributed than EV-B.CVA4 was mainly detected in northern,central,and western Henan,while CVA10 was found primarily in northern,central,and southern regions.EV-B strains were mainly distributed in eastern and southern Henan.Seasonally,higher detection rates were observed in summer and autumn,with lower rates in winter and spring.EV-A showed a bimodal distribution with a peak in October,whereas EV-B strains were mainly detected from June to August.These findings indicate that in 2023,NPEVs isolated from AFP cases in Henan Province were predominantly CVA4 and CVA10 of the EV-A group,representing a notable shift from previous years when EV-B serotypes predominanted.Continued surveillance of NPEVs is essential to establish baseline data for early warning and prediction of potential outbreaks caused by these viruses.
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基本信息:
DOI：10.13242/j.cnki.bingduxuebao.250027
中图分类号:R181.3;R512.4
引用信息:
[1]杨建辉,张明瑜,张璐等.2023年河南省急性弛缓性麻痹病例中非脊髓灰质炎肠道病毒病原学及流行病学分析[J].病毒学报,2025,41(03):634-644.DOI:10.13242/j.cnki.bingduxuebao.250027.
基金信息: