2023监测年上海市奉贤区甲型H3N2亚型流感病毒分子流行特征分析  

Molecular epidemiological characterization of influenza A(H3N2)virus in Fengxian District,Shanghai,in the surveillance year of 2023

作　　者：赵宏伟 陶力新 谢晓红[1] 胡屹[2] 赵雪 刘梅花 张庆媛 陆丽婕 刘晨安 吴梅 ZHAO Hongwei;TAO Lixin;XIE Xiaohong;HU Yi;ZHAO Xue;LIU Meihua;ZHANG Qingyuan;LU Lijie;LIU Chen’an;WU Mei(Fengxian District Center for Disease Control and Prevention,Shanghai 201499,China;School of Public Health,Fudan University,Shanghai 200032,China;Institute for the Control of Pathogenic Organisms,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China)

机构地区：[1]上海市奉贤区疾病预防控制中心,上海201499 [2]复旦大学公共卫生学院,上海200032 [3]上海市疾病预防控制中心病原生物检定所,上海200336

出　　处：《上海预防医学》2025年第1期18-22,28,共6页Shanghai Journal of Preventive Medicine

基　　金：上海市加强公共卫生体系建设三年行动计划(2023—2025年)(GWⅥ-3);2022年度奉贤区社会类科技发展基金(医学类)项目(20221429)。

摘　　要：【目的】了解2023年上海市奉贤区甲型H3N2亚型流感病毒流行分布及基因进化变异情况,为流感预防和控制提供参考依据。【方法】分析奉贤区2023流感监测年(2023年4月—2024年3月)流感病毒流行情况,将75株H3N2流感病毒的血凝素(HA)基因、神经氨酸酶(NA)基因、氨基酸序列与疫苗参考株进行相似性比对和系统发育进化分析,并分析基因特征和变异情况。【结果】奉贤区2023年春季H3N2和H1N1亚型流感混合流行,下半年以H3N2为主,2024年春季乙型Victoria成为主要优势型别。75株H3N2流感毒株HA和NA基因主要分布在3C.2a1b.2a.2a.3a.1分支和B.4分支上,与2024年疫苗参考株的整体相似性高于2022年和2023年的疫苗参考株。与2023年疫苗参考株对比,HA发生3个抗原位点和1个受体结合位点的改变,减少3个糖基化位点,新增2个糖基化位点;NA出现7个抗原位点和第222位耐药位点改变,减少2个糖基化位点。【结论】该地区H3N2亚型流感病毒产生抗原变异且耐药风险均较高,需要加强2024年流感疫苗接种的宣传教育并长期监测流感病毒流行和变异水平。[Objective]To understand the epidemiological distribution and gene evolutionary variation of influenza A(H3N2)viruses in Fengxian District,Shanghai,in the surveillance year of 2023,and to provide a reference basis for influenza prevention and control.[Methods]The prevalence of influenza virus in Fengxian District in the 2023 influenza surveillance year(April 2023‒March 2024)was analyzed.The hemagglutinin(HA)gene,neuraminidase(NA)gene,and amino acid sequences of 75 strains of H3N2 influenza viruses were compared with the vaccine reference strain for similarity matching and phylogenetic evolutionary analysis,in addition to an analysis of gene characterization and variation.[Results]In Fengxian District,there was a mixed epidemic of H3N2 and H1N1 in the spring of 2023,with H3N2 being the predominant subtype in the second half of the year,and Victoria B becoming the predominant subtype in the spring of 2024.A total of 75 influenza strains of H3N2 with HA and NA genes were distributed in the 3C.2a1b.2a.2a.2a.3a.1 and B.4 branches,with overall similarity to the reference strain of the 2024 vaccine higher than that of the reference strain of the 2022 and 2023 vaccine.Compared with the 2023 vaccine reference strain,three antigenic sites and one receptor binding site were changed in HA,with three glycosylation sites reduced and two glycosylation sites added;where as in NA seven antigenic sites and the 222nd resistance site changed with two glycosylation sites reduced.[Conclusion]The risk of antigenic variation and drug resistance of H3N2 in this region is high,and it is necessary to strengthen the publicity and education on the 2024 influenza vaccine and long-term monitoring of influenza virus prevalence and variation levels.

关 键 词：甲型H3N2亚型流感病毒 血凝素 神经氨酸酶 分子流行特征 

分 类 号：R183.3[医药卫生—流行病学]