2006-2007年我国五岁以下住院儿童轮状病毒流行病学研究

Molecular epidemiology of rotavirus among children under 5 years old hospitalized for diarrhea in China

目的了解我国五岁以下儿童以医院为基础的轮状病毒性腹泻的流行情况。方法按照WHO轮状病毒胃肠炎监测标准，监测9家医院，收集从2006年1月至2007年12月五岁以下全部的住院腹泻儿童标本4047份，轮状病毒检测采用酶联免疫吸附试验（ELISA），毒株分型采用RT-PCR方法。结果共检测3862份标本，检出阳性标本1700份，轮状病毒感染阳性率44．0％。病毒性腹泻患儿发病呈现季节性分布，主要集中在秋冬季（10月份至1月份）。轮状病毒感染95．4％发生在2岁前的婴幼儿。在12～17、9～11、18～23月年龄段为53．2％、50．2％、48．3％。轮状病毒流行株以P[8]G3为主，占58．4％，其次是P[8]G1，占22．0％，P[4]G1占3．0％，P[8]G9占2．4％，2例P[10]G2，1例P[10]G3，出现1例P[8]G5，没有检出G4血清型，世界各地常见的组合P[8]G1、P[4]G2、P[8]G3、P[8]G4占80．8％。结论轮状病毒感染是引起婴幼儿腹泻主要原因之一，开发应用安全有效的轮状病毒疫苗对减轻轮状病毒疾病负担有重要作用。

Objective To study molecular epidemiology of Rotavirus among children under 5 years of age in china. Methods Stool specimens were collected from 4047 inpatients under 5 years of age with diarrhea in our 9 hospital-based surveillance sites from January 2006 to December 2007 following the WHO Rotavirus surveillance protocol. Rotavirus were detected by ELISA, Further strain characterization of rotavirus was carried out with RT- PCR. Results A total of 4047 stool samples were collected and 3862 of total stools were tested among which 1700 was positive. The Rotavirus positive rate is 44.0% . A peak admission of rotavirus diarrhea was observed from November to next January. More than 95.4% of viral diarrhea patients occurred in their first 2 years. The incidence rates of rotavirus diarrhea were highest in 12-17 months of age. The most common rotavirus strain was P[8]G3（58.3% ）; followed by P[8]G1 （22.1%）, P[4]G1 （3.0%）, P[8]G9 （2.4%）. G4 was not detected in this study. The four common strains were 80.8 % in the world. Conclusion Rotavirus diarrhea was an important infectious disease among children under 5 years of age in China. Safe and effective rotavirus vaccines for the prevention of rotavirus diarrhea and reduction of treatment costs are of significant importance to China.