Outbreak of central nervous system disease associated with hand, foot, and mouth disease in Japan during the summer of 2000: Detection and molecular epidemiology of enterovirus 71
Outbreak of central nervous system disease associated with hand, foot, and mouth disease in Japan during the summer of 2000: Detection and molecular epidemiology of enterovirus 71
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DOI：
10.1111/j.1348-0421.2002.tb02743.x
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发表时间：
2002-01-01
影响因子：
2.6
通讯作者：
Nishio, O
中科院分区：
文献类型：
--
作者：
Fujimoto, T;Chikahira, M;Nishio, O
2000年之前，日本很少报告过影响中枢神经系统（CNS）的严重肠道病毒71型（EV71）感染的暴发。2000年6月至8月期间，一名患者因脑干脑炎引起的肺水肿并伴有EV71诱发的手足口病（HFMD）死亡，许多患者并发包括瘫痪在内的严重中枢神经系统疾病，在日本的禁区住院。 日本兵库县（K 区）。同一时期，兵库县其他地区也报告了手足口病流行，手足口病患者中分离出EV71，但很少有患者发展为无菌性脑膜炎。使用Vero细胞很难从K区患者中分离EV71，因此使用GL37细胞分离菌株；然而，Vero 细胞可以从兵库县其他地区分离出 EV71 株。我们对这些EV71分离株的VP4编码区进行了测序，发现来自K区的分离株具有相同的序列，除了1个分离株外，与兵库县其他地区分离的EV71株的序列不同。尽管这些结果不足以说明来自K区的EV71是一种强毒株，但可以合理地得出K区严重中枢神经系统疾病是由EV71引起的结论，因为它是K区住院患者中检测到的唯一传染源。
Few outbreaks of the serious enterovirus 71 (EV71) infections, which affect the central nervous system (CNS), had been reported in Japan before 2000. During June through August 2000, a patient died of pulmonary edema caused by brainstem encephalitis accompanied by EV71-induced hand, foot, and mouth disease (HFMD), and many patients complicated by serious CNS disease, including paralysis, were hospitalized in a restricted area in Hyogo Prefecture, Japan (K-area). During the same period, endemics of HFMD were reported in other areas in Hyogo Prefecture, where EV71 was isolated from HFMD patients, but few patients developed aseptic meningitis. The isolations of EV71 from K-area patients were difficult with the use of Vero cells, so the strains were isolated by use of GL37 cells; Vero cells, however, could isolate EV71 strains from other areas in Hyogo Prefecture. We sequenced VP4 coding regions of these EV71 isolates and found that the isolates from K-area had the same sequence, which, except for one isolate, was different from the sequences of EV71 strains isolated from other areas of Hyogo Prefecture. Although these results were not enough to state that EV71 from K-area was a virulent strain, it seemed reasonable to conclude that serious CNS diseases in K-area were caused by EV71 because it was the only infectious agent detected in the inpatients of K-area.