中缅边境地区不明原因发热病人蚊媒病毒性疾病分子流行病学调查  

Molecular epidemiological survey of mosquito-borne viral diseases in patients with a fever of unknown origin at the border between China and Myanmar

作　　者：田杰 郭晓芳[2] 周红宁[2] 刘永华[3] 尹小雄 吴超[2] 杨明东[2] 杨中华[2] 李萍[3] 郑宇婷[2] 李春敏[2] TIAN Jie;GUO Xiao-fang;ZHOU Hong-ning;LIU Yong-hua;YIN Xiao-xiong;WU Chao;YANG Ming-dong;YANG Zhong-hua;LI Ping;ZHENG Yu-ting;LI Chun-min(School of Public Health,Kunming Medical University,Kunming,China 650500;The International Base for Training Scientific&Technological Personnel in Tropical Diseases in South Asia&Southeast Asia,Yunnan Provincial Key Laboratory of Vector-borne Infectious Disease Control and Research,Yunnan Institute of Parasitic Diseases,Pu’er,Yunnan,China 665000;Department of Infectious Disease Control and Prevention,Ruili Center for Disease Control and Prevention)

机构地区：[1]昆明医科大学公共卫生学院,云南昆明650500 [2]云南省寄生虫病防治所,云南省虫媒传染病防控研究重点实验室,云南省虫媒传染病防控关键技术创新团队(培育) [3]瑞丽市疾病预防控制中心传染病防制科

出　　处：《中国病原生物学杂志》2021年第5期590-595,613,共7页Journal of Pathogen Biology

基　　金：国家自然科学基金项目(No.81560548)。

摘　　要：目的了解中缅边境地区不明原因发热病人感染的蚊媒病毒种类,为当地蚊媒传染病防控提供科学依据。方法采用实时荧光RT-PCR法对2014-2015年在瑞丽市采集的1738份登革病毒NS1抗原检测阴性的不明原因发热病人血清进行Dengue virus(DENV)、Chikungunya virus(CHIKV)、Zika virus(ZIKV)、Sindbis virus(SINV)、Banna virus(BAV)、Batai virus(BATV)和Tahyna virus(TAHV)的检测,并将阳性标本接种于C6/36白纹伊蚊细胞进行病毒分离和鉴定,对阳性血清或新分离病毒株提取病毒RNA进行E基因RT-PCR扩增,测序后进行同源性和进化分析。结果从2015年采集的血清标本中检出1份ZIKV阳性,17份DENV阳性(6份DENV-1,6份DENV-2,未分型5份),从2014年采集的标本中检出1份DENV-1阳性。病毒分离得到1株ZIKV,2株DENV-1和2株DENV-2。对新分离ZIKV病毒株进行E基因测序,属于亚洲基因型,与2019年输入云南的缅甸株(2019YNZIKV02)进化关系较近。对2015年DENV阳性血清PCR产物测序,获得3条DENV-1E基因序列(本地病例),均属于基因1型,与2015年缅甸输入株进化关系较近;3条DENV-2均属于亚洲基因型(Asian Genotype),其中2条来源于本地病例序列和1条缅甸病例序列均与2015年缅甸输入的DENV-2亲缘关系较近。结论从中缅边境地区不明原因发热病人血清中检测和分离到ZIKV,并发现登革热漏检病例,提示亟待提高当地临床医生对寨卡病毒病的诊断意识并积极开展寨卡病毒病的常规监测,对疑似登革热病人需采用抗原和DENV、ZIKV病毒核酸检测方法联检以避免漏检。Objective To ascertain the types of mosquito-borne viruses in cases of a fever unknown origin at the China-Myanmar border and to provide a scientific basis for the prevention and control of mosquito-borne diseases.Methods A total of 1,738serum samples from patients with an unexplained fever and a negative dengue fever virus(DENV)NS1antigen test were collected in Ruili from 2014to 2015.Of those samples,657(37.80%)were collected in 2014and 1,081(62.20%)were collected in 2015.Patients consisted of 930males(53.51%)and 808females(46.49%).The youngest patient was 2months old and the oldest was 96years old,with a median age of 24years.One thousand seven hundred and five samples(98.10%,1705/1738)were collected from June to October.One thousand two hundred and fifty serum samples(71.92%)were collected within one week of onset,19(1.10%)were collected more than one week after onset,and the date of onset was unknown for 469(26.99%).Real-time RT-PCR was used to detect DENV,Chikungunya virus(CHIKV),Zika virus(ZIKV),Sindbis virus(SINV),Banna virus(BAV),Batai virus(BATV),and Tahyna virus(TAHV)in those serum samples.Differences in the rate of detection were analyzed with a 2test using the software SPSS 20.0,and P<0.05was considered to indicate a significant difference.Positive samples were inoculated on C6/36Aedes albopictus cells for virus isolation and identification.RNA was extracted from positive serum samples or new isolates,and the E(envelope)gene of the virus was amplified using RT-PCR and sequenced.Sequence homology was determined and phylogenetic analysis of the E gene was performed bioinformatically.Results 1.Real-time RT-PCR:A total of 18DENV-positive samples(rate of detection:1.036%)and 1ZIKV-positive sample(rate of detection:0.058%)were detected.BAV,BATV,TAHV,CHIKV,and SINV were not detected.One ZIKV-positive sample was collected in October 2015,and case was autochthonous.Eighteen DENV-positive samples included 7DENV-1positive samples from 6 autochthonous cases(all collected in June 2015)and 1imported case from Myanm

关 键 词：不明原因发热 虫媒病毒 分子流行病学 中缅边境地区 

分 类 号：R384.1[医药卫生—医学寄生虫学]