2007-2010年湖南省肾综合征出血热监测及病毒种系进化分析

Epidemiologic and phylogenetic study on hemorrhagic fever with renal syndrome in Hunan province from 2007 to 2010

目的分析2007-2010年湖南省肾综合征出血热(HFRS)的流行特征及病毒基因的分型与种系进化。方法对2007-2010年湖南省传染病监测信息报告管理系统网络直报的HFRS病例资料及疫情监测资料运用描述性流行病学方法对人间与啮齿类动物间的疫情进行分析和比较,应用免疫荧光试验(IFA)、RT-PCR技术对HFRS病例血清样本及鼠肺组织样本进行病原学检测,对病毒M基因特征进行生物信息学分析。结果 4年间14地市(州)共报告HFRS病例2 115例,病死率为1.28%;疫情主要分布在湘中的娄底和邵阳地区,农民占67.19%;共布鼠夹55 289次,捕鼠2 316只,鼠肺组织总带毒率为2.18%;疫区类型为姬鼠型为主的混合型;2份HFRS患者血清及1份鼠肺组织HTNV特异性引物与分型引物RT-PCR扩增为阳性;病毒在进化上与84Fli株在同一组内,核苷酸序列高度同源;3株病毒均为HTNV型、H5亚型病毒株。结论近年来湖南省HFRS发病率和死亡率总体呈现下降趋势,受某些因素的影响,局部地区疫情相对较严重;病毒M基因同国内其他毒株比较,未发生较大变异。

Objective To study the epidemiological features of hemorrhagic fever with renal syndrome（HFRS） and to analyze the molecular evaluation of the virus M gene.Methods Descriptive epidemiology was applied to analyze the epidemic data collected from both the national notifiable disease reporting system and the local surveillance records of HFRS including human and rodent endemics.IFA and RT-PCR were used to determine the etiology from blood samples of patients and lung tissues of rodents.Meanwhile the virus M gene was sequenced and analyzed by bioinformatics.Results A total of 2 115 HFRS cases reported from 2007 to 2010 in 14 areas of Hunan province with the mortality of 1.28%.Most of the cases were from Loudi and Shaoyang counties and 67.19% of patients were farmers.Also IFA test revealed that 2.18% of all the captured mice were found to be Hantavirus positive in their lung tissues,and apodemus agrarius was the major host of the virus in this endemic area.PCR products of two blood samples and one mouse lung tissue were positive with both HTNV general primers and specific typing primers.The phylogenetic tree showed that these three isolated viruses had a high homogeneity with 84Fli strain,which were classified as H5 subtype of HTNV.Conclusions The overall downward trend of HFRS epidemics in Hunan province could be related to the successful control strategies,but in some areas the epidemic situation is still serious,and the M gene ofHantavirus has not changed a lot compared with others.