2018年中国麻疹风疹疑似病例的实验室检测和监测  

Measles and Rubella Suspected Cases:Laboratory Testing and Monitoring Analysis in China in 2018

作　　者：胡满丽 张燕[1] 王慧玲[1] 朱贞[1] 毛乃颖[1] 崔爱利[1] 许文波[1,2] HU Manli;ZHANG Yan;WANG Huiling;ZHU Zhen;MAO Naiying;CUI Aili;XU Wenbo(National Institute for Viral Diseases Control and Prevention,China CDC,NHC Key Laboratory of Medical Virology and Viral Diseases,WHO WPRO Regional Reference Measles/Rubella Laboratory,Beijing 102206,China;Center for Biosafety Mega Science,Chinese Academy of Sciences,Wuhan 430071,China)

机构地区：[1]中国疾病预防控制中心病毒病预防控制所,国家卫生健康委员会医学病毒和病毒病重点实验室,世界卫生组织西太平洋地区麻疹/风疹参比实验室,北京102206 [2]中国科学院生物安全大科学研究中心,武汉430071

出　　处：《病毒学报》2020年第1期20-25,共6页Chinese Journal of Virology

基　　金：国家科技重大专项课题(项目号:2018ZX10711001),题目:病毒感染高通量快速检测与应急筛检技术研究;“十三五”国家科技重大专项课题(项目号:2018ZX10713002),题目:病毒性传染病病原谱和病毒基因变异变迁规律研究;“十三五”国家科技重大专项课题(项目号:2017ZX10104001 002),题目:暴发相关的呼吸道传播病毒全基因组数据库的建立和分子分型标准化方法的研究、质量控制和推广应用;“十三五”国家科技重大专项课题(项目号:2018ZX10713001 003),题目:病毒性自然疫源性传染病症候群病原谱构成及流行规律研究。

摘　　要：2018年中国麻疹发病达到历史最低,多个省份已经达到<1/100万临近消除状态。为评估在麻疹低发病情况下,中国麻疹风疹实验室网络(Measles/rubella laboratory network,MRLN)检测的敏感性、准确性和及时性,本文对2018年中国麻疹监测系统(Measles surveillance system,MSS)中的检测和监测数据和国家麻疹风疹实验室(National measles/rubella laboratory,NMRL)病毒学监测数据库进行了分析。结果显示,2018年全国麻疹风疹监测共报告38 634例病例,其中散发病例36 340例,散发病例的血清和病原学标本采集率分别为98.75%、58.53%。麻疹、风疹IgM检测阳性率分别为10.51%(3892/37036)、8.85%(3243/36653)。麻疹、风疹病毒核酸检测阳性率分别为7.55%(1444/19116)、7.82%(1478/18905)。NMRL病毒学监测数据库显示:2018年共从23个省分离到301株麻疹病毒,其中13株为D8基因型,3株为B3基因型,14株为A基因型,271株H1基因型;从14个省共分离358株风疹病毒,其中1E基因型265株,2B基因型93株。2018年NMRL和省级地市级实验室分别接受了WHO和国家实验室针对血清学和分子检测的盲样考核,各实验室均顺利通过了考核。综上表明,2018年中国MRLN维持高水平运转,为麻疹、风疹消除提供有效的实验室科技支撑。In 2018,the incidence of measles in China reached the lowest in history,and many provinces have reached <1/1 million. To evaluate the sensitivity,accuracy and timeliness of the measles and rubella laboratory network(MRLN) test in China with low incidence of measles,this article analyzes Measles Surveillance System(MSS) detection and surveillance data and the National Measles/Rubella Laboratory(NMRL)virology surveillance database in 2018. Results showed that there were 38,634 cases of measles and rubella surveillance reported in 2018,36,340 of which were sporadic cases. The serum collection rates and pathogenic specimens of sporadic cases were 98.75% and 58.53%,respectively. The positive rates of measles and rubella IgM were 10.51%(3,892/37,036)and 8.85%(3,243/36,653),respectively. The positive rates of measles and rubella virus nucleic acid detection were 7.55%(1,444/19,116) and 7.82%(1,478/18,905),respectively. In 2018,MSS isolated 175 measles viruses from 17 provinces,of which 8 were D8 genotype,3 were B3 genotype,9 were A genotype(vaccine-related strains)and 155 were H1 genotype(Chinese native dominant strain). 347 rubella virus strains were obtained from 10 provinces,including 268 strains of 1 E genotype and 79 strains of 2 B genotype. A total of 301 measles viruses were collected from 23 provinces by measles/rubella laboratories(MRL),of which 13 were D8 genotype,3 were B3 genotype,14 were A genotype and 271 were H1 genotype. 358 strains of rubella virus were detected from 14 provincial MRLs,including 265 strains of 1 E genotype and 93 strains of 2 B genotype. In summary,China’s MRLN maintains a high level of operation in 2018,providing reliable laboratory technical support for elimination of measles and rubella in China.

关 键 词：麻疹风疹实验室网络(MRLN) 麻疹监测系统(MSS) 病毒学监测 血清学检测 核酸检测 质量控制 

分 类 号：R373.1[医药卫生—病原生物学]