陈建华, 于德山, 刘东鹏, 苟发香, 武海卓, 高强, 申明星. 甘肃省康县儿童腺病毒7型流行特征与病原学分析[J]. 疾病监测, 2016, 31(7): 575-580. DOI: 10.3784/j.issn.1003-9961.2016.07.010
引用本文: 陈建华, 于德山, 刘东鹏, 苟发香, 武海卓, 高强, 申明星. 甘肃省康县儿童腺病毒7型流行特征与病原学分析[J]. 疾病监测, 2016, 31(7): 575-580. DOI: 10.3784/j.issn.1003-9961.2016.07.010
CHEN Jian-hua, YU De-shan, LIU Dong-peng, GOU Fa-xiang, WU Hai-zhuo, GAO Qiang, SHEN Ming-xing. Outbreak of acute respiratory disease caused by of adenovirus type 7 in Kangxian, Gansu[J]. Disease Surveillance, 2016, 31(7): 575-580. DOI: 10.3784/j.issn.1003-9961.2016.07.010
Citation: CHEN Jian-hua, YU De-shan, LIU Dong-peng, GOU Fa-xiang, WU Hai-zhuo, GAO Qiang, SHEN Ming-xing. Outbreak of acute respiratory disease caused by of adenovirus type 7 in Kangxian, Gansu[J]. Disease Surveillance, 2016, 31(7): 575-580. DOI: 10.3784/j.issn.1003-9961.2016.07.010

甘肃省康县儿童腺病毒7型流行特征与病原学分析

Outbreak of acute respiratory disease caused by of adenovirus type 7 in Kangxian, Gansu

  • 摘要: 目的 探讨甘肃省陇南市康县儿童腺病毒7型的流行病学及病原学特征。方法 采用统一的流行病学个案调查表对病例进行调查,采集病例咽拭子样本118份,采用实时荧光聚合酶链反应(PCR)方法对流感病毒(influenza virus, Flu)、呼吸道合胞病毒(respiratory syncytial virus, RSV)、呼吸道腺病毒(human adenovirus, HAdV)等12种病原进行初筛检测。对HAdV核酸初筛阳性样本进行病毒分离,并对分离到的病毒株进行Hexon基因片段测序,核酸序列采用ClustalⅩ和Mega 6.0软件进行分析。结果 2014年12月20日至2015年2月2日共报告118例感染病例,均为儿童,年龄最小的仅2个月,最大的11岁,分布在康县21个乡镇中的17个乡镇,1岁27例,1~岁37例,2~岁40例;5岁14例,其中男性67人,女性51人,男女性别比为1.31:1。临床特征以发热、咳嗽、咽痛为主,部分病例伴扁桃体发炎、腹泻等症状。实验室确诊为HAdV感染的有33例,分布在13个乡镇。118例病例咽拭子经实时荧光PCR检测,HAdV阳性33例,流感病毒H3N2阳性7例,RSV阳性6例,HAdV和RSV混合感染2例。HAdV阳性标本用Hep-2细胞分离到病毒18株。中国疾病预防控制中心病毒病预防控制所复核HAdV717株,HAdV31株,毒株测序结果表明,HAdV7毒株同源性高达100%,所有毒株位于同一分支上。结论 该起儿童呼吸道感染疫情的主要病原是HAdV7;疫情初期为H3N2流感病毒感染,后期RSV病毒感染病例使疫情持续时间延长;当地的恶劣气候,医院门诊对发热患者未按要求进行预检分诊,输液大厅、儿科病房等通风条件差,病例拥挤是本次疫情扩散的主要原因。

     

    Abstract: Objective To understand the epidemiological and etiological characteristics of an outbreak of acute respiratory tract infection in Gansu province. Methods Descriptive epidemiological survey was conducted to describe the epidemiological characteristics of the disease and 118 swabs were collected from the cases for real-time PCR detections of 12 possible pathogens, including influenza A and B viruses, respiratory syncytial virus (RSV), human adenoviruses (HAdVs). Virus isolation was conducted for the samples which were positive in HAdVs detection and the isolated strains were sequenced for Hexon fragment, and the nucleotide sequence was analyzed with software ClustalⅩ and Mega 6.0. Results From 20 December 2014 to 2 February 2015, a total of 118 infection cases were reported, all the cases were children aged 2 months to 11 years. The cases were distributed in 17 of 21 townships of Kangxian, including 27 cases in age group1 year, 40 cases in age group 2-5 years and 14 cases in age group 5 years. Sixty seven cases occurred in boys and 51 cases occurred in girls (1.31:1). The main symptoms included fever, cough and sore throat, and some cases had quinsy and diarrhea. Thirty three HAdV infection cases were laboratory confirmed, which were distributed in 13 townships. Real-time PCR indicated that 33 cases were HAdV7 infections, 7 cases were influenza A(H3N2), 6 cases were RSV infections and 2 cases were co-infected with HAdV and RSV. Eighteen strains of HAdV were isolated by using Hep-2 cells, in which 17 were confirmed by China CDC. One strain of HAdV1 was isolated. The sequencing analysis showed that all the HAdV7 strains, sharing 100% homology, were on the same branch. Conclusion The acute respiratory tract infection epidemic in children was mainly caused by HAdV7, but by influenza A (H3N2) virus in early stage and RSV in late stage. Bad climate, poor management of fever cases, poor ventilation and crowding in hospitals were the risk factors for the outbreak.

     

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