甘肃武威市门诊腹泻儿童轮状病毒和诺如病毒腹泻流行特征分析

Epidemiological Characteristics of group A rotavirus and norovirus infection among children with diarrhea in Wuwei,Gansu province

目的分析武威市5岁以下儿童轮状病毒和诺如病毒腹泻的流行病学特征。方法收集武威市两所哨点医院2012-2014年门诊腹泻患儿粪便标本,采用酶联免疫吸附实验（ELISA）法检测轮状病毒（RV）抗原,检出的阳性标本用逆转录-聚合酶链反应（RT-PCR）进行G/P基因分型;采用RT-PCR检测诺如病毒（NoV）,分析流行病学特征。结果共采集182份粪便标本,A组RV抗原阳性率为29.12%,男女性别差异有统计学意义（χ^2=182.000,P〈0.001）;2岁以下儿童为RV高发人群,高发与低发年龄段RV阳性率差异有统计学意义（χ^2=219.576,P〈0.001）;发病高峰出现在5月、11月,5月份阳性率最高,高发与低发月份阳性率差异有统计学意义（χ^2=279.000,P〈0.001）。RV G、P分型,以G9、G3、P[8]型为主要流行株,G、P型组合模式分析显示：最常见的是G9＋P[8],其次是G3＋P[8]。NoV抗原阳性率为15.93%,病例年龄均为2岁以下儿童;发病也呈现两个高峰,分别为4月最高峰和12月次高峰,高发与低发月份阳性率差异具有统计学意义（χ^2=159.641,P〈0.001）;对NoV阳性标本进行分型,GI型占55.17%,GII型占44.83%。A组RV和NoV混合感染阳性率为6.04%。结论 RV和NoV是武威市5岁以下儿童腹泻的主要病原体,应根据流行特征做好预防工作。

Objective To explore the epidemiological characteristics of group A rotavirus （RV） and norovirus （NOV） infection among children under the age of five with diarrhea in Wuwei city. Methods The stool specimens were collected from children＇s outpatients with diarrhea in two sentinel hospitals from 2012 to 2014. Group A RV was detected by enzyme- linked immunosorhent assay （ELISA）, and the positive specimens were used to make G/P genotyping with reverse tran- scription polymerase chain reaction （RT-PCR）. The NoV was also detected by RT-PCR. Results A total of 182 stool samples were collected,the RV antigenositive was 53 strains, and the positive rate was 29. 12%. The difference between male and female was statistically significant （x^2 = 182. 000, P〈0. 001）. The cases were mainly concentrated in children aged 0-23 months. There was statistically significant difference in the positive rate between high-risk age group and the low-risk age group （x^2= 219. 576, P〈0. 001）. The peak appeared in May and November, and November had the highest positive rate. There was statistically significant difference in the positive rate in high-risk month and the low-risk month （x^2 = 279. 000,P〈0. 001）. For the G/P genotyping, the style of G9,G3,P[8] were the main epidemic strains. While the analysis of G, P type combination mode showed the main epidemic strains were G9＋P[8], followed by the G3-P[8]. Additionally, the NoV antigen-positive rate was 15.93%. All cases were children under the age of two. In one year,the incidence of NoV also had two peaks, which were in April and December. There was also statistically significant difference in positive rates among the high-risk month and the low risk month （x^2 = 159. 641 ,P〈0. 001）. In the taping of the two NoV positive specimens,one was GI accounted for 55.17 %. One was GII,accounted for 44.83 %. And the mixed infection positive rate of group A RV and NoV was 6.04 %. Conclusion The group A RV and NoV are the main pathogens for children under the age of five infected diarrhea in Wuwei city,the related prevention work should be carried out according to the epidemiological characteristics.