云南中缅边境一起输入性登革热暴发的分子流行病学研究  

An outbreak of imported dengue fever from Myanmar to the border of China, with its viral molecular epidemiological features

作　　者：张海林[1] 付士红[2] 邓掌[1] 袁军[1] 姜红月[2] 李铭华[2] 高晓艳[2] 王静林[1] 刘永华[3] 尹正留 杨卫红[1] 章域震[1] 冯云[1] 王环宇[2] 梁国栋[2] 

机构地区：[1]云南省地方病防治所云南省病毒立克次体研究中心,大理671000 [2]中国疾病预防控制中心病毒病预防控制所 [3]云南省瑞丽市疾病预防控制中心

出　　处：《中华流行病学杂志》2013年第5期428-432,共5页Chinese Journal of Epidemiology

基　　金：中美新发和再发传染病合作项目（U19-GH000004）;国家自然科学基金（30560142）

摘　　要：目的调查云南中缅边境一起输入性登革热流行状况及其流行病毒株的分子流行病学特点。方法采集医院就诊和口岸入境人员中登革热、疑似登革热和不明原因发热患者血清标本并进行流行病学调查，采用ELISA检测登革病毒IgM抗体，RT-PCR检测登革病毒核酸，核酸阳性标本进行登革病毒PrM-C和NS5区的基因核苷酸序列测定和分析。结果2008年7—11月在云南省瑞丽市共采集急性期患者血清标本103份，经登革病毒IgM抗体和核酸检测，49例确诊为登革热。其中除1例为当地感染病例，其余48例均为输人性病例，其中18例来自缅甸木姐市居民，30例为中国居民到缅甸经商或务工返回后发病者。从缅甸输入病例血清中获得2株病毒（RLB61和RLC31）的PrM-C和NS5区基因核苷酸序列，同源性和系统进化分析表明，RLB61株为登革1型病毒，RLC31株为登革3型病毒，与东南亚登革病毒流行株具有较近的亲缘关系。结论经血清学和分子流行病学证实瑞丽市边境地区发生输入性登革热暴发，并间接证实缅甸木姐市2008年存在登革1和3型病毒流行。Objective To understand the epidemiologic characteristics of dengue fever, imported from Myanmar to the border of Yunnan province, China. Viral molecular epidemiologic features were also studied. Methods Questionnaires were used on each diagnosed, suspected dengue fever, case or unknown cases with fever when coming from Myanmar entering the port and hospitals in Ruili city of Yunnan province. Serum samples of these patients were collected to detect IgM antibody against dengue virus and RT-PCR assay. Homology and phylogenetic tree based on the whole nucleotide sequence of PrM-C and NS5 gene of dengue virus were further analyzed. Results A total of 103 sera were collected from patients at acute stage in Ruili city in July to November 2008. Among them, 49 cases were confirmed for dengue fever according to IgM and nucleic acid testings. Except one, other 48 cases were all imported into Ruili, from Myanmar. Of those, 18 patients were residents from Mujie city of Myanmar and hospitalized in Ruili and the rest 30 patients were Chinese citizens who had finished business and returned from Myanmar. Two isolates of serum samples from the imported cases were identified and both homology and phylogenetic analysis were performed, using the nucleotide sequences of PrM and NS5 genes. They were divided into dengue type 1 （RLB61） and dengue type 3 （RLC31） and were closer to the dengue virus strains isolated from Southeast Asia countries. Conclusion It is confirmed that an epidemic of dengue fever which was imported from Myanmar to Ruili city of Yunnan province, China. Evidence also showed that both type I and III epidemic strains of dengue virus did exist in Mujie city of Myanmar in 2008.

关 键 词：登革热 登革病毒 输入性流行 分子流行病学 

分 类 号：R181[医药卫生—流行病学] R51[医药卫生—公共卫生与预防医学]