2017年云南省西双版纳州登革1型病毒暴发疫情的调查研究

范建华; 冯云; 朱进; 李鸿斌; 高阳; 李卫平; 刀应华; 张婧; 邹建红; 李俊明; 容艺函宇; 张海林

doi:10.3784/j.issn.1003-9961.2019.05.013

2017年云南省西双版纳州登革1型病毒暴发疫情的调查研究

An outbreak of dengue serotype 1 virus in Xishuangbanna prefecture of Yunnan province, China, 2017

摘要

摘要:
目的调查2017年云南省西双版纳傣族自治州（西双版纳州）登革热暴发疫情的流行病学特征和登革病毒（DENV）流行株血清型和遗传进化特征。
方法收集登革热病例资料，采集2017年该地登革热患者急性期血清标本，用反转录–聚合酶链式反应扩增DENV C/PrM和E基因核苷酸序列，用MEGA 5.0软件构建系统发生树。
结果2017年西双版纳州共确诊登革热1 348例，包括本地感染病例1 231例和输入病例117例。景洪市、勐腊县和勐海县均有来自老挝和缅甸的输入性病例，其中景洪市和勐腊县发生本地流行，病例数分别为1 030例和201例。流行期为5 — 12月，病例年龄以20 ~ 54岁为主，男女性别比为1∶1.16。从患者血清中获得48株DENV的C/PrM区基因核苷酸序列进化分析结果表明，其中46株为登革1型病毒（DENV-1；景洪市33株、勐腊县10株和勐海县3株），2株为登革2型病毒（DENV-2；勐腊县和勐海县各1株）。 2017年西双版纳州的老挝输入病例和本地感染病例的DENV -1流行株间高度同源，与近几年德宏州瑞丽市和临沧市耿马县及东南亚国家的DENV-1流行株具有较近的遗传进化关系。 DENV-1的E基因进化分析结果与C/PrM一致。
结论DENV-1是引起2017年西双版纳州登革热暴发疫情的主要病原。来自老挝的登革热输入性病例是导致2017年西双版纳州本地登革热流行的主要原因，应加强中国−老挝和中国−缅甸边境地区登革热跨境传播的防控。

Abstract:
ObjectiveTo understand the epidemiologic, virologic and genetic characteristics of an outbreak of dengue fever in Xishuangbanna prefecture of Yunnan province in 2017.
MethodsThe incidence data of dengue fever in Xishuangbanna were collected. The serum samples from acute patients were collected to detect the nucleic acid of dengue virus by reverse transcription- polymerase chain reaction(RT-PCR) assay. Coding regions of C/prM and E genes of dengue virus were amplified by RT-PCR and sequenced. The phylogenetic tree was constructed by Neighbor-Joining methods of MEGA 5.0 software.
ResultsA total of 1 348 laboratory confirmed dengue fever cases were reported in Xishuangbanna in 2017, in which 1 231 were indigenous cases (91.32%), 117 were imported cases (8.68%). Imported cases from Laos and Myanmar were reported in Jinghong, Mengla and Menghai counties of Xishuangbanna, and indigenous cases occurred in Jinghong (1 030, 83.67%) and Mengla (201, 16.33%). The epidemic of dengue fever lasted from May to December. The majority of patients were aged 20－54 years, the youngest was 2 year-old and the oldest was 89 year-old. The male to female ratio of the cases was 1∶1.16. Phylogenetic analysis on nucleotide sequences of C/PrM of 48 virus strains obtained from the serum samples of dengue fever cases indicated that the 46 strains belonged to dengue virus serotype 1 (DENV-1), in which 33 from Jinghong, 10 from Mengla and 3 from Menghai and 2 strains belonged to dengue virus serotype 2 (DENV-2), in which 1 from Mengla and 1 from Menghai. The DENV-1 strains from imported cases of Laos shared high homology with the strains from indigenous cases.These DENV-1 strains from Xishuangbanna had closer genetic relationship with the DENV-1 strains isolated from Ruili county of Dehong prefecture and Gengma county of Lincang prefecture of Yunnan and the countries of southeastern Asia in recent years.
ConclusionThe dengue fever epidemic occurred in Xishuangbanna in 2017 was mainly caused by DENV-1. The imported dengue fever cases from Laos were the main sources for the indigenous transmission of dengue fever in Xishuangbanna. It is necessary to strengthen control of the cross-border spread of dengue fever in this area.

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