某幼儿园一起脑炎疫情流行病学及病原研究  

Research on an encephalitis epidemic event in a kindergarten by epidemiology and etiology

作　　者：邱晓枫[1] 谢立[1] 黄志成[1] 杨旭辉[1] 王婧[1] 潘劲草[1] 

机构地区：[1]杭州市疾病预防控制中心,浙江杭州310021

出　　处：《中国卫生检验杂志》2014年第3期309-311,315,共4页Chinese Journal of Health Laboratory Technology

基　　金：杭州市科技发展计划项目(20120633B22)

摘　　要：目的查明杭州某县市一家幼儿园无菌性脑炎疫情的流行病学特征及病原。方法通过查阅幼儿园晨检、因病缺课记录；某医院发热门诊就诊记录和现场个案调查展开流行病学调查。采集患儿粪便、血清标本先通过荧光FIT—PCR和ELISA方法初筛，然后选肠道病毒通用阳性标本进行病毒分离、培养；通过逆转录一聚合酶链反应（RT-PCR）鉴定上述培养物，并扩增埃可病毒9型（简称ECHO-9）VP1区全长基因和序列测定，利用生物信息学软件对序列进行分析，构建基因进化树。结果该幼儿园共累计报告病例18例，发热、头痛、呕吐为主要症状。从采集的7份样本中分离到ECHO阳性毒株2株，VP1基因全序列测定结果显示其与ECHO-9代表株核苷酸和氨基酸的相似性最高，分别为73．5％～93．6％、85．4％-97．0％。结论引起此次疫情的病原为ECHO-9。进化树分析表明与近年来已报道的ECHO-9相比有一定的亲缘关系。Objective To reveal the epidemiological characteristics and pathogens of an epidemic of children aseptic encephali- tis in a kindergarten in one city of Hangzhou. Methods An epidemiological survey of this disease was carried out through con- sulting the record of morning test and absence for illness in kindergarten, the visit record of fever clinic in a hospital, and on - the - spot investigation. The feces and serum samples of patients were detected by using fluorescent RT - PCR and ELISA for preliminary screening of enterovirns. Then the enterovirus in positive specimens were identified by RT - PCR after isolation and culture. The full - length VP1 gene of echovirus 9 strains were amplified and sequenced. Then sequence analysis by bioinforma- tics software was conducted to construct phylogenetic tree. Results Eighteen viral encephalitis cases were reported in the kin- dergarten altogether, with fever, headache, vomiting as the main symptoms. Two ECHO viral strains were isolated from 7 speci- mens. VP1 gene complete sequence analysis indicated that the two strains belonged to echovirus type 9, due to high similarity to nucleotide and amino acid of echovirns type 9 reference strains, 73.5% - 93.6% and 85.4% -97.0% respectively. Conclu- sion The echovirus type 9 was confirmed to cause the children viral encephalitis outbreak in the kindergarten in one city of Hangzhou. Phylogenetic tree analysis showed a certain genetic relationship between the pathogen and the reported ECHO -9 in recent years.

关 键 词：埃可病毒9型 病毒性脑炎 VP1基因 

分 类 号：R512.3[医药卫生—内科学]