福建省不明原因发热和病毒性脑炎患者病毒感染的实验室检测(英文)

Laboratory diagnoses of patients with unknown fever and viral encephalitides in Fujian Province,China

目的了解福建省不明原因发热、病毒性脑炎患者中病毒感染类型与流行特征。方法于2010年1-12月采集医院中就诊的不明原因发热和病毒性脑炎患者血清和脑脊液标本。使用免疫学和分子生物学方法检测患者标本中5种常见病毒(乙型脑炎病毒、埃可病毒、柯萨奇病毒、单纯疱疹病毒和腮腺炎病毒)特异性IgM抗体和病毒基因。结果共采集到382例发热和病毒性脑炎患者标本,其中发热患者128例(128份急性期血清),病毒性脑炎患者254例(176份急性期血清,78份脑脊液)。检测结果显示,共81例患者标本检测到病毒感染阳性,其中不明原因发热患者血清的病毒IgM抗体阳性率为28.9%(37/128),病毒性脑炎患者血清的病毒IgM抗体或脑脊液的PCR阳性率为17.3%(44/254)。肠道病毒感染在所有病例中所占比例最高为66.7%(54/81),在1-10岁病毒感染阳性患者中肠道病毒感染占74.4%(29/39)。8份脑脊液标本检测病毒核酸阳性中,7份为肠道病毒阳性,1份为单纯疱疹病毒阳性。流行病学分析显示,病毒感染阳性标本分布在3-12月,除了乙型脑炎病例全部集中在7-8月以外,其他病毒感染未见明显季节聚集性。结论实验室检测发现,2010年全年在福建省部分医院采集的发热和病毒性脑炎患者标本中存在肠道病毒、乙型脑炎病毒、腮腺炎病毒和单纯疱疹病毒感染,以肠道病毒感染为主。

Viral encephalitides （VE） are excluded in the list of notifiable infectious diseases for lack of systemic monito- ring and specific laboratory test methods in China. In this study, the etiological profile of patients with unknown fever and viral encephalitides was investigated in three prefectures in Fujian Province between January and December, 2010. Among the 382 patients, serum specimens from 128 unknown fever cases and 176 viral encephalitis cases, and cerebrospinal fluid specimens from 78 viral encephalitis cases were collected. Five causative agents for viral encephalitides including Japanese encephalitis virus （JEV）, echovirus （ECHOV）, coxsackie virus （CoxV）, herpes simplex virus （HSV）, and mumps virus （MuV） were de- tected by virus-specific IgM antibody enzyme-linked immunosorbent assays （ELISA） and nucleic amplification tests （NAT）. Eighty-one specimens were detected positive in either one test, with positive rates of 37/128 in unknown fever cases and 44/176 in viral encephalitis cases, respectively. It was revealed by NAT that 8 specimens were positive, including 7 infection cases of ECHOV and CoxV, and one HSV infection. Remarkably, the infection rate of enteroviruses （EVs） ranked （54/382） on top of the virus panel, accounting for 74.4% （29/39） in positive cases of the 0-10 year-old group. Apart from JE that had a single ep- idemic peak in july and August, no seasonal cluster was observed from March to December by epidemiological analysis. There- fore, four viruses, i. e. , EVs, JEV, MuV and HSV, contributed to unknown fever and viral encephalitis cases in Fujian Prov- ince, 2010, while EV infections were predominant.