赵丹妮, 李华昌, 张汉菊, 施靖, 郭继文, 杨力, 邓伟, 杜青云, 郭晓芳. 2019年云南省耿马县发热病例中登革病毒、基孔肯雅病毒和寨卡病毒感染情况分析[J]. 疾病监测, 2024, 39(6): 711-717. DOI: 10.3784/jbjc.202305040194
引用本文: 赵丹妮, 李华昌, 张汉菊, 施靖, 郭继文, 杨力, 邓伟, 杜青云, 郭晓芳. 2019年云南省耿马县发热病例中登革病毒、基孔肯雅病毒和寨卡病毒感染情况分析[J]. 疾病监测, 2024, 39(6): 711-717. DOI: 10.3784/jbjc.202305040194
Zhao Danni, Li Huachang, Zhang Hanju, Shi Jing, Guo Jiwen, Yang Li, Deng Wei, Du Qingyun, Guo Xiaofang. Dengue virus, chikungunya virus, and zika virus infections in febrile cases in Gengma county, Yunnan province, in 2019[J]. Disease Surveillance, 2024, 39(6): 711-717. DOI: 10.3784/jbjc.202305040194
Citation: Zhao Danni, Li Huachang, Zhang Hanju, Shi Jing, Guo Jiwen, Yang Li, Deng Wei, Du Qingyun, Guo Xiaofang. Dengue virus, chikungunya virus, and zika virus infections in febrile cases in Gengma county, Yunnan province, in 2019[J]. Disease Surveillance, 2024, 39(6): 711-717. DOI: 10.3784/jbjc.202305040194

2019年云南省耿马县发热病例中登革病毒、基孔肯雅病毒和寨卡病毒感染情况分析

Dengue virus, chikungunya virus, and zika virus infections in febrile cases in Gengma county, Yunnan province, in 2019

  • 摘要:
    目的 探讨2019年中缅边境地区云南省临沧市耿马县发热病例感染虫媒病毒的种类,回顾性分析其流行病学与病原学特征,为本地区发热病例的早期诊断及虫媒传染病的防控提供科学依据。
    方法 收集2019年9—10月耿马县定点医院收治的发热病例信息,采集病例血清用美国登革病毒(DENV)NS1抗原检测试剂检测抗原,并提取病毒RNA用三重实时荧光反转录-聚合酶链式反应(RT-PCR)进行DENV、基孔肯雅病毒(CHIKV)和寨卡病毒(ZIKV)的核酸检测;对DENV阳性样本再用实时荧光RT-PCR法进行血清型分型检测;选取病毒载量较高的样本,对目的基因测序后进行系统进化分析。
    结果 在946份本地发热病例血清样本中,共检出104份DENV阳性(10.99%),其中33份DENV-1,21份DENV-2,36份DENV-3,14份未分型,DENV NS1抗原检测试剂法的假阴性率为20.19%;43份CHIKV阳性(4.54%);6例ZIKV阳性(0.63%)。 对阳性RNA进行RT-PCR产物测序,获得8条DENV-1 NS5基因序列,相似性为97.70%~100.00%,均属基因Ⅰ型,与近年来缅甸等东南亚国家的流行株亲源关系较近;获得1条DENV-2 NS5基因序列,属城市基因型,与2013年新加坡输入株进化关系较近;获得4条CHIKV E2基因序列,相似性为99.30%~100.00%,均属中东南非基因型,与同年云南省瑞丽市流行株亲源关系较近。
    结论 2019年中缅边境地区临沧市耿马县发生了登革热、基孔肯雅热和寨卡病毒病的混合流行,在本地发热病例血清中首次检出CHIKV和ZIKV,提示中缅边境地区应提高对登革热、基孔肯雅热及寨卡病毒病等虫媒病毒病的诊断意识,优化虫媒病毒检测方案,尽可能发现潜在传染源,为有效预防和控制中缅边境地区虫媒传染病提供科学依据。

     

    Abstract:
    Objective To explore the species of arboviruses causing febrile cases in Gengma, a county in the China-Myanmar border, in Lincang city, Yunnan province in 2019, and analyze the epidemiological and etiological characteristics of arbovirus infection retrospectively and provide evidence for the early diagnosis of febrile cases and the prevention and control of vector-borne diseases.
    Methods Clinical data of febrile cases treated at designated hospitals in Gengma county from September to October 2019 were collected. Serum samples were collected from the cases and tested for viral antigens using a dengue virus NS1 antigen detection kit, and viral RNA was extracted for real-time fluorescence reverse transcription-polymerase chain reaction (RT-PCR) for the nucleic acid detection of dengue virus, chikungunya virus, and zika virus. Dengue virus-positive samples were further subjected to serotyping by real-time fluorescence RT-PCR. Samples with high viral loads were selected for amplification of target genes sequencing for phylogenetic analysis.
    Results   In 946 serum samples from local febrile cases, 104 were positive for dengue virus (10.99%), including 33 dengue virus-1, 21 dengue virus-2, 36 dengue virus-3, and 14 unspecified samples. The false negative rate of the dengue virus NS1 antigen detection test was 20.19%. Additionally, 43 samples were positive for chikungunya virus (4.54%), and 6 cases were positive for zika virus (0.63%). Sequencing of positive RNA by RT-PCR obtained 8 sequences of dengue virus-1 NS5 gene, with a similarity of 97.70% to 100.00%, belonging to genotype I and showing close homology with epidemic strains in Myanmar and other Southeast Asian countries in recent years. One sequence of dengue virus-2 NS5 gene was obtained, belonging to the Cosmopolitan genotype, and showing close evolutionary relationship with the imported strains from Singaporean in 2013. Four sequences of chikungunya virus E2 gene were obtained, with a similarity of 99.30% to 100.00%, belonging to the east/central/south African genotype and showing close homology with epidemic strains in Ruili city in the same year.
    Conclusion In 2019, dengue fever, chikungunya fever, and zika virus disease co-spreaded in Gengma county, Lincang city, China-Myanmar border area. Chikungunya virus and zika virus were detected in local febrile cases for the first time, suggesting that it is necessary to immprove the diagnosis of vector-borne viral diseases such as dengue fever, chikungunya fever, and zika virus disease, optimize the detection protoccol for vector-borne virus infection and identify potential infection sources as much as possible for the effective prevention and control of vector-borne diseases in the China-Myanmar border area.

     

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