云南省62例发热患者中蚊传虫媒病毒感染的病原学检测

Detection of mosquito-borne arbovirus infectious in sixty two feverish patients of Yunnan

目的 查明云南省疑似蚊传虫媒病毒感染的发热患者中病原体的种类及生物学特性.方法 针对2013年昆明市第三人民医院传染科收集的62例疑似蚊传虫媒病毒感染发热患者急性期血清标本,使用血清学和分子生物学方法对这些标本开展3种蚊媒病毒（登革病毒、乙脑病毒和基孔肯雅病毒）感染的检测.结果 62例血清标本中,27例呈现蚊媒病毒感染阳性,占全部病例44％（27/62）.检测阳性患者中,82％（22/27）为登革病毒感染,18％（5/27）为乙脑病毒感染,未检测到基孔肯雅病毒感染阳性.全部登革病毒感染患者均显示登革病毒IgM抗体阳性,其中含12例患者呈登革病毒基因检测阳性.登革病毒分型结果显示,12例登革病毒基因检测阳性标本中含有3种血清型登革病毒,分别为,1型登革病毒（5例）,3型登革病毒（5例）,4型登革病毒感染（2例）.5例病例标本为乙脑病毒IgM抗体阳性,未检测到乙脑病毒基因阳性.流行病学分析结果显示,登革和乙脑病例主要发生在6-10月.且22例登革病毒感染中19例患者为输入性病例.结论 云南省疑似蚊传病毒感染发热患者以登革病毒感染为主,且登革病毒感染阳性病例大部分为输入性病例,感染的登革病毒来源于东南亚国家的流行株.

Objective To find out the pathogens that caused the feverish patients suspected with mosquito-borne arboviral infection in Yunnan.Methods Totally 62 acute phase serum samples were collected from the feverish patients suspected with mosquito-borne arboviral infection in the third people＆#39;s hospital of Kunming city.The detection of three kinds of mosquito-borne virus,including Dengue virus （DENV）,Japanese encephalitis virus （JEV） and Chikungunya virus （CHKV）,were carried out using molecular biological methods and serological methods.Results The results show that 27 serum samples are tested positive to mosquito-borne viral infection,accounting for 44% of all cases （27/62）.Among these positive cases,82% （22/27） of them are DENV infection,18% （5/27） JEV infection,and no CHKV infection cases.All the DENV cases are shown DENV IgM antibody positive,which include 12 cases nucleotide test positive to DENV.DENV genotyping results indicate that three different genotypes are identified among these 12 nucleotide-positive cases,namely genotype 1 （5 cases）,genotype 3 （5 cases） and genotype 4 （2 cases）.In addition,there are also 5 JEV IgM antibody-positive cases and JEV nucleotide-positive cases are not identified.The epidemiological analysis reveals that cases of DENV and JEV are mainly distributed in June to October.And 19 cases among the DENV infection cases （n =22） are imported cases.Conclusions DENV infection cases have a large proportion of suspected cases with mosquito-borne arboviral infection in Yunnan,and these DENV-positive cases are mainly imported cases.The strains of DENV identified in this study are primarily derived from Southeast Asian countries.