一例非蜱传发热伴血小板减少综合征死亡病例的病原学鉴定

Etiological identification of a death case with non-tick bites transmitted severe fever with thrombocytopenia syndrome

目的通过对该病例的临床症状、流行病学及病原学检测鉴定来说明该病在发病时间、传播媒介、传播途征有待进一步研究。方法采用新布尼亚病毒特异性核酸与抗原检测,病毒分离与核苷酸序列比对分析等技术对病例进行确诊。结果在病例的4份血清中均检测到新布尼亚病毒核酸,3份血清中分离到新布尼亚病毒,经病毒特异性抗原和L、M、S三个基因检测、核苷酸序列测定和BLAST比对,均符合新布尼亚病毒的病原学特征。结论该病例的发病时间、传播途征及传播媒介上虽然得不到流行病学支持,但在临床症状、临床化验及病原学鉴定上均符合卫生部关于发热伴血小板减少综合征防治指南确诊病例条件,通过该病例分析与病原学鉴定,对该病的发病季节、传播途征、传播媒介等流行病学特征。

Objective By analyzing the clinical symptoms,epidemiology and etiology identification of severe fever with thrombocytopenia syndrome（ SFTS）,to demonstrate the necessity of further investigations on the time of disease onset,the mediums and routes of disease transmission. Methods Novel Bunyavirus specific nucleic acid and antigen were detected in serum samples from SFTS patients. Virus isolation and nucleotide sequence alignment methods were used to confirm the disease. Results Novel Bunyavirus nucleic acid were detected in all the 4 serum samples from the patient,and Bunyavirus were successfully isolated from three serum samples. The results of specific antigen detection,genetic analysis of L,M and S virus genes,DNA sequencing and BLAST showed that these isolated viruses shared the same characteristics with novel Bunyavirus. Conclusion Although the onset time,transmission routes and medium of this case were not in accordance with the epidemical study,the clinical characteristics,medical laboratory tests and etiology identification were well in line with the case criteria of SFTS prevention guidelines. The analysis and etiology identification of current cases would be beneficial for the further exploration,investigation and confirmation of the epidemiology features of this disease,such as onset season,the medium and routes of the disease transmission.