丽水市境外务工输入性登革热病例调查分析  

Investigation and analysis of imported dengue fever cases among foreign workers in Lishui City

作　　者：王晓光[1] 叶碧峰[1] 杨秀丽 叶灵[1] WANG Xiao-guang;YE Bi-feng;YANG Xiu-li;YE Ling(Lishui Municipal Center of Disease Control and Prevention,Lishui,Zhejiang 323000,China)

机构地区：[1]丽水市疾病预防控制中心,浙江丽水323000

出　　处：《中国卫生检验杂志》2021年第22期2789-2792,共4页Chinese Journal of Health Laboratory Technology

基　　金：浙江省卫生325高层次人才资助项目;浙江省医药卫生科技计划项目(2020RC153)。

摘　　要：目的对1例柬埔寨境外务工输入的登革热病例开展流行病学调查和实验室辅助鉴定验证病原体。方法隔离病房收集病例流行病学和临床资料,急性期血清使用胶体金法和Real-time PCR法检测DENV抗原、抗体和核酸,C6/36细胞分离鉴定出病毒后Sanger双脱氧法测定全基因,序列组装和分析通过生物信息学软件处理,进行全基因和ancC、prM、E基因多序列比对溯源。结果病例早期血清中IgM抗体阳性并检测到DENV抗原NS1和Ⅰ型核酸的存在,在C6/36细胞中分离到病毒随后鉴定为DENVⅠ型。LSDFV01编码区主要结构和非结构蛋白关键位点未变异,没有碱基缺失和插入,进上化属于DENVⅠ型,与毗邻的柬埔寨、越南、泰国的序列最近缘。结论病例有旅外务工居住史,在柬埔寨生活期间有明确的蚊虫叮咬史,结合流行病学及病史、相关辅助鉴定结果和全基因测序溯源均指示输入性登革热诊断明确,入院物理隔离治疗预后良好。登革热是丽水地区外来输入的传染病,输入性病例、蚊媒高密度和临床漏诊可能会导致局部疫情暴发。Objective An epidemiological investigation and laboratory-assisted identification of a dengue fever case imported by a Cambodia migrant worker were carried out.Methods Epidemiological and clinical data of patients were collected in the isolation ward.DENV antigen,antibody and nucleic acid were detected by colloidal gold method and real-time PCR in serum of acute stage.After virus was isolated and identified in C6/36 cells,the whole gene was determined by Sanger dideoxidation method,and sequence assembly and analysis were processed by bioinformatics software.The whole gene and ancC,prM and E genes were traced by multiple sequences alignment.Results In the early stage,IgM antibody was positive and the presence of DENV antigen NS1 and type I nucleic acid was detected.The virus was isolated in C6/36 cells and subsequently identified as DENV type 1.The key sites of main structural and non-structural proteins in the coding region of LSDFV01 were not mutated,and there was no base deletion or insertion.The evolution of LSDFV01 belonged to DENV I type,and it was closest to the sequences of Cambodia,Vietnam and Thailand.Conclusion The patient had a history of working overseas and a clear history of mosquito bites in Cambodia.Combined with the epidemiology and history,the results of related assisted identification and the traceability of whole gene sequencing,the diagnosis of imported dengue fever was clear and the prognosis was good after physical isolation treatment in hospital.Dengue fever is an imported infectious disease in Lishui City.Imported cases,high density of mosquitoes and missed clinical diagnosis may lead to local outbreaks.

关 键 词：登革热 登革热病毒 流行病学 检测 

分 类 号：R446[医药卫生—诊断学]