病毒学报

广东省手足口病(Hand,foot,and mouth disease,HFMD)监测数据显示,2018年5～7月非肠道病毒A组71型(Enterovirus A71,EV-A71)、非柯萨奇病毒A16型(Coxsackievirus A16,CV-A16)和非柯萨奇病毒A6型(Coxsackievirus A6,CV-A6)的其他肠道病毒(以下简称"其他EV")阳性率大幅度增高,经鉴定60%为柯萨奇病毒A10型(Coxsackievirus A10,CV-A10)。因此,为了解广东省2018年HFMD病原谱及CV-A10的基因特征,本研究收集2018年哨点监测数据进行统计分析,采集HFMD其他EV标本进行分型鉴定,并随机选取2008～2018年CV-A10阳性标本开展VP1全长序列测序与分析。结果显示,广东省2018年HFMD病原谱包括24种肠道病毒,阳性率位于前三位的分别是CV-A16(30.73%)、CV-A6(24.29%)和CV-A10(≈11.0%)。CV-A10主要流行于5～7月份,且在各市广泛流行,所致HFMD重症率低于EV-A71,却高于CV-A16和CV-A6。遗传进化分析发现,CVA10可分为A、B、C、D、E、F、G 7个基因型,C基因型包括C0、C1和C2 3个亚型。广东省211株CV-A10中,2株为B基因型,2株为C1亚型,207株为C2亚型。207株C2亚型包括3个基因群,其中C2a基因群16株,流行于2008～2012年;C2b基因群36株,流行于2010～2014年和2016年;C2c基因群155株,流行于2011～2018年。根据以上结果表明,广东省2018年HFMD病原以柯萨奇A组肠道病毒为主,其中CV-A10是引起5～7月份手足口病暴发优势病原之一。基于VP1基因分析,CV-A10可分为A、B、C、D、E、F和G等7个基因型。广东省存在B和C基因型,其中C基因型的C2c基因群是优势流行株。

From May to July in 2018,the positive rate of non-EV-A71/CV-A16/CV-A6 enteroviruses(other enterovirus) causing hand,foot,and mouth disease(HFMD) in Guangdong Province,China,increased significantly,and 60% were identified as coxsackievirus A10(CV-A10). To study the etiological spectrum of HFMD and genetic characteristics of CV-A10 in Guangdong Province,China,we examined other enterovirus samples of HFMD cases collected in 2018. VP1 region of CV-A10 positive samples were amplified and sequenced,which were collected from 2008 to 2018. Results showed that the etiological spectrum of HFMD included 24 serum types of enterovirus in Guangdong Province,China,in 2018,with the top three positive rates being CV-A16(30.73%),CV-A6(24.29%)and CV-A10(≈11.0%),respectively. CV-A10 was prevalent from May to July and was widely spread in 21 cities in Guangdong Province,China,in 2018. CV-A10 was significantly associated with a higher risk of severe HFMD when compared to CV-A16 or CV-A6,but with a lower risk than EV-A71. The phylogenetic analysis results indicated that CV-A10 can be divided into seven genotypes:A,B,C,D,E,F,G,and the C genotype included C0,C1 and C2 sub-genotype. Of the 211 CVA10 strains in Guangdong Province,China,2 strains were B genotypes,2 strains were C1 subtypes,and 207 strains were C2 subtypes(including C2 a,C2 b and C2 c genogroups). Of the 207 C2 subtype strains,16 C2 a genogroup strains circulated during 2008 to 2012,36 C2 b genogroup stains circulated during 2010 to 2014 and2016,155 C2 c genogroup stains circulated during 2011 to 2018. According to the above results,the main pathogens of HFMD in Guangdong Province,China,in 2018 were coxsackievirus A group enterovirus,among which CV-A10 was one of the dominant pathogens causing HFMD outbreak from May to July. CV-A10 can be divided into A,B,C,D,E,F,and G genotypes based on the sequence analysis of VP1 region. Genotype B and C were identified and the C2 c genogroup were the prevalent strains in Guangdong Province,China.