杭州市2017年Ⅱ型登革热暴发疫情流行情况及E基因序列分析  

Epidemiological characteristics of type Ⅱ dengue fever outbreak in Hangzhou in 2017

作　　者：孙昼[1] 丁华[1] 任晓宾[1] 考庆君[1] 温圆圆[1] 王婧[1] 潘劲草[1] SUN Zhou;DING Hua;REN Xiao-bing;KAO Qing-jun;WENG Yuan-yuan;WANG Jing;PANG Jin-cao Hangzhou(Municipal Center for Disease Control and Prevention,Hangzhou,Zhejiang 310021,China)

机构地区：[1]杭州市疾病预防控制中心

出　　处：《中国预防医学杂志》2019年第9期839-843,共5页Chinese Preventive Medicine

基　　金：杭州市重大科技项目(20162013A03);杭州市科委引导项目(20163501Y37)

摘　　要：目的分析杭州市2017年登革热暴发疫情流行病学特征,为制订登革热防控措施提供科学依据。方法从国家《疾病监测信息报告管理系统》和杭州市各区、县(市)疾病预防控制中心收集个案调查资料,采用描述性流行病学方法分析流行病学特征。采集患者血清进行登革病毒核酸和抗体检测,提取病毒核酸后扩增E基因并测序,利用生物信息学软件进行多序列比对排列及构建进化树。采用布雷图指数法进行蚊媒密度监测。结果本次暴发疫情历时110 d,共报告病例1338例,病例主要集中在13个区、县(市),男女罹患率差异无统计学意义,发病年龄最小1岁,最大95岁,以50岁及以上老年人为主;职业分布以离退人员(30.41%)、商业服务(13.88%)、家务及待业者(12.91%)居多。共分离到128株病毒株,挑选11株代表性病毒株进行E基因序列比对及进化分析,分离的病毒株均属登革病毒Ⅱ型(世界流行株),分为3个不同的病毒分支,同源性分析显示与马来西亚、新加坡等东南亚国家及云南省分离株同源性高。结论本次疫情为输入性病例引发的Ⅱ型登革病毒本地感染暴发疫情,时间长、范围大、呈现多个输入源、多点暴发的特点。Objective To understand the epidemiological characteristics of dengue fever outbreak in Hangzhou in 2017,and to provide scientific basis for disease prevention and control.Methods Data of patients with dengue fever in Hangzhou in 2017 were retrieved from China information system for disease control and prevention and local CDCs and were analyzed for disease epidemiological characteristics using descriptive epidemiological method.E gene of dengue virus was amplified and sequenced and analyzed using constructed phylogenetic tree.Results During the outbreak which lasted for 110 days,a total of 1338 cases were reported.Cases were mainly from 13 districts and counties in Hangzhou.The difference was not significant between the number of male and female cases.Majority of patients were older than 50,with the youngest of 1 year old and the oldest of 95 years old.Most patients were retirees(30.41%),businessmen(13.88%),house keepers and unemployed(12.91%).A total of 128 strains of dengue virus were isolated.The homologous and phylogenetic analysis showed that the 11 selected isolates were all belonged to dengue virus type II and grouped into 3 clades,which had closest phylogenetic relationship with the strains isolated from cases in Malaysia,Singapore and Yunnan province.Conclusions The dengue virus type II outbreak is triggered by imported dengue fever cases,with characteristics of longer epidemic period,wider affected area,multiple input sources and multi-site outbreaks.

关 键 词：登革热 暴发 流行病学 登革病毒 E基因 序列 进化分析 

分 类 号：R183.5[医药卫生—流行病学]