2012年广东省5岁以下儿童腹泻病流行特征及重点病原监测  

Epidemiological and etiological characteristics of diarrheal disease among children under 5 years of age in Guangdong province, in 2012

作　　者：孙立梅[1] 李晖[1] 谭小华[1] 方苓[1] 邓爱萍[1] 莫艳玲[1] 何剑峰[1] 柯昌文[1] 林锦炎[1] 

机构地区：[1]广东省疾病预防控制中心,广州511430

出　　处：《中华流行病学杂志》2013年第10期989-992,共4页Chinese Journal of Epidemiology

基　　金：广东省医学科研项目（A2012085）

摘　　要：目的探讨广东省〈5岁儿童腹泻病流行特征和重点病原监测。方法2012年在广东省21个地市选择64家医院开展腹泻症状监测，其中14家医院采集〈5岁儿童腹泻病粪便标本，开展霍乱弧菌、志贺菌分离培养及轮状病毒、诺如病毒ELISA、PCR检测。分析52周腹泻病症状监测数据和1932例〈5岁儿童腹泻病重点病原监测结果。结果2012年广东省〈5岁儿童腹泻就诊病例占监测门诊就诊总人次数的0．8％，占监测门诊全年龄组腹泻病例就诊总人次数的63．5％；以医院为基础报告〈5岁儿童感染性腹泻病年发病率为1454．5／10万。全年采集〈5岁儿童腹泻病标本1932份，检测霍乱弧菌均为阴性，宋内志贺菌1例阳性，轮状病毒阳性率为14．1％（273／1932），诺如病毒阳性率为16．9％（326／1932），诺如病毒和轮状病毒合并感染24例（1．2％）。112份轮状病毒和90份诺如病毒阳性标本测序表明，轮状病毒主要以G1[P8]为主（33．9％），其次为G9[P8]（25．9％）、G2[P4]（12．5％）、G3[P8]（9．8％）；诺如病毒以GⅡ-4型为主（76．7％），并检出5份GI型和16份GⅡ其他型／变异株，除6月（未开展测序工作）和12月外其余各月均检出GⅡ．4／2006b型（占50．0％），GII．4／Sydney2012变异株于8月首次检出并在12月成为流行优势株。结论〈5岁儿童是广东省腹泻病高危人群，感染的轮状病毒和诺如病毒具有基因多样性。Objective To analyze the epidemiological and etiological characteristics of diarrheal disease among children under 5 years of age in Guangdong province, in 2012. Methods 64 hospitals in 21 cities were chosen as the diarrheal syndromic surveillance sites, of which 14 hospitals were selected to carry out etiological surveillance among children under 5 years of age, including isolation and culture of both Vibrio cholera and Shigella as well as nucleic acid detection of rotavirus and norovirus by PCR. Descriptive method was used to analyze data from syndromic and etiological surveillance programs on diarrheal, from 1932 parents of the children. Results In 2012, the outpatient attendance rate on diarrheal among children under 5 years was 0.8%. The proportion of diarrheal in children under 5-year-olds was 63.5%, among the total number of diarrheal outpatients at the outpatient clinics under surveillance program. The morbidity of infectious diarrhea was 1454.5/10 million in children under 5 years of age. A total number of 1932 specimens were collected from children under 5 years of age, in the outpatient department. Among these specimens, Vibrio cholera appeared all negative but one was Shigella positive and proved to be Sh. sonnei. The positive rates of rotavirus and norovirus were 14.1% （273/1932） and 16.9% （326/1932）. Both rotavirus and norovirus were found in 24 specimens, with a positive rate as 1.2%. 112 specimens were successfully gene- sequenced for rotavirus, of which 33.9% as G1 [P8] genotype, 25.9% as G9 [PSI, 12.5% as G2 [P4] and 9.8% as G3 [P8] respectively. 90 specimens were successfully gene-sequenced for norovirus, of which 76.7% as G II.4 genotype. Genetic subtypes of G II .4/2006b, accounted for 50.0% and could be detected around the year except for June and December. New G II .4/Sydney Strain_2012 was first detected in August and became the predominant in December. In addition, 5 specimens belonged to G I genotype with other 16 subtypes of G II. Conclusion Results from our study proved that ch

关 键 词：腹泻病 症状监测 轮状病毒 诺如病毒 基因分型 

分 类 号：R181.3[医药卫生—流行病学]