山东省1例人粒细胞无形体病的确认与调查

Investigation on a case of human granulocytic anaplasmosis in Shandong Province

目的对1例可疑人粒细胞无形体病病例进行病原学实验诊断与流行病学个案调查。方法按照卫生部下发的《人粒细胞无形体病流行病学调查方案(试行)》进行个案调查。采用套式-聚合酶链反应(nested-PCR)技术检测病例血液中人粒细胞无形体16SrRNA基因。结果人粒细胞无形体DNA检测为阳性,测序分析显示与浙江、吉林野鼠检出的无形体相应序列同源性99%以上。结论该病例为山东省2008年疫情网络直报首起人粒细胞无形体病突发公共卫生事件报告病例,并经实验室检测确诊,符合卫生部下发的《人粒细胞无形体病预防控制技术指南(试行)》中的病例诊断标准。证明山东省存在人粒细胞无形体感染病例,进一步开展自然疫源地调查工作十分必要。

In order to investigate a patient who was suspect to be infected with Human Granulocytic Anaplasmosis （HGA） in Shandong Province, epidemiological investigations were carried out in this case according to Epidemiological Investigation Scheme on HGA and blood samples were collected for laboratory tests. Nested-PCR assay was used to detect the 16S rRNA gene of HGA in blood samples and sequence analysis was followed. The patient showed typical clinical symptoms and epidemiological characterizations of HGA. PCR amplification result was positive and sequence analysis demonstrated that the homology of nucleotide sequences was 99.7% comparing with the corresponding parts of HGA found in wild mice in Zhejiang and Jilin Province. According to the registered GenBank sequences, the detected 16S rRNA gene was different at only one bps which lied in the 117 bps. This case was one of the cases reported during the first outbreak of public health incident about HGA in 2008, and was confirmed by laboratory tests and diagnosed as HGA according to the criteria in the guide book of HGA control and prevention issued by Ministry of Public Health. This report indicated that the HGA infection in human has existed in Shandong Province and it’s necessary to carry out further epidemiological investigations in the natural foci.