2011-2013年济南市发热伴血小板减少综合征流行病学及病原学特征分析

Analysis on epidemiological and etiological features of severe fever with thrombocytopenia syndrome in Jinan in 2011-2013

目的分析济南市2011-2013年发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome,SFTS)的流行病学特征和病原学特性,为更好地预防和控制SFTS提供科学依据。方法采用实时荧光定量RT-PCR方法检测济南市2011-2013年SFTS疑似病例急性期血清样本和蜱虫样本中的SFTS布尼亚病毒核酸,采用RT-PCR方法进行扩增并测序,使用DNASTAR和MEGA软件对测序结果进行序列比对和进化分析;用描述性流行病学方法对监测数据进行统计分析。结果 2011-2013年济南市共确诊95例SFTS病例,检测出3只蜱虫样本中的SFTS布尼亚病毒核酸阳性;发病地区主要集中在章丘市。对SFTS布尼亚病毒的S片段基因进行测序,结果显示2012年SFTS布尼亚病毒基因与安徽、江苏、河南分离株遗传距离相对较近。2013年SFTS布尼亚病毒基因与山东本地分离株遗传距离相对较近。结论济南市发热伴血小板减少综合征病例以新布尼亚病毒为其主要病原;夏秋季多发;中老年农民为主,具有明显职业性;发病范围逐年扩大,局部地区疫情活跃。应加强传染源的管理控制,深入开展对高危人群宣传教育和行为干预。

Objective To analyze the epidemiological and etiological characteristics of severe fever with throm- bocytopenia syndrome （SFTS） in Jinan, and to provide scientific evidence for disease control. Methods Real-time PCR was used to amplify nucleic acid of bunyavirus in samples collected from patients or suspected cases with SFTS as well as from ticks in Jinan from 2011 to 2013. The sequences of PCR products were aligned and analyzed using DNASTAR and MEGA software. A descriptive epidemiological method was used to analyze data. Results From 2011 to 2013, 95 confirmed SFTS cases were reported Zhangqiu. The S gene sequence close to strains from Anhui, Ji half were from analysis revealed that the virus strains isolated in 2012 were phylogenetically angsu and Henan, while those isolated in 2013 were close to strains from other areas in Shandong. Conclusions Bunyavirus is found to he the major pathogen of SFTS in Jinan, which is still very much active in local area, especially in summer and fall. Majority of virus strains are genetically related.