河南省2013—2015年病毒性腹泻哨点医院监测结果与分析

Surveillance for viral diarrhea in sentinel hospitals in Henan province, 2013-2015

目的 分析2013-2015年河南省监测哨点5岁以下腹泻儿童轮状病毒（HRV）、人感染杯状病毒（HuCV）、人感染星状病毒（HAtV）及肠道腺病毒（EAdV）的感染状况。方法 采集4个哨点医院腹泻儿童住院病例粪便样本880份，ELISA法检测A组HRV并进行G/P基因分型；二步法多重RT-PCR检测B/C组HRV、HuCV和HAtV，单重PCR检测EAdV；对阳性病例进行流行病学统计分析。结果 共检出阳性样本594份（含混合感染样本24份）：HRV 370份，阳性率42.0%，男性感染率高于女性，农村高于城市，小年龄组高于大年龄组；HuCV 162份，阳性率18.4%；HAtV 69份，阳性率7.8%；EAdV 17份，阳性率1.9%，3种病毒的城市总阳性率高于农村。A组HRV存在以G9P［8］为主的多种型别，秋季和春季有两个显著高峰；HuCV以诺如Ⅱ型为主，存在春季感染高峰。阳性病例以0-12月龄（HRV）和3-5岁（HuCV）为主；临床存在不同程度的发热、腹泻、呕吐等症状，性别及地区分布存在病原学差异。结论 河南省监测哨点5岁以下患儿中存在较高的腹泻病毒感染率，不同感染类别呈现不同的流行病学及临床特点。

Objective To investigate the infection status of human rotavirus, calicivirus, astrovirus and enteric adenovirus in children aged 〈5 years in disease surveillance areas in Henan province from 2013 to 2015. Methods A total of 880 stool samples were collected from four sentinel hospitals and group A rotavirus was detected by ELISA and group A rotavirus G/P genotyping was performed with nested multiplex RT-PCR, while rotavirus （group B, C）, calicivirus and astrovirus were detected by two-step multiplex RT-PCR and adenovirus were detected by PCR. The epidemiological data of positive cases were statistically analyzed. Results A total of 594 positive samples were detected, including 24 mixed infection samples, 370 rotavirus positive samples （42.0%）; 162 calicivirus positive samples （18.4%）; 69 astrovirus positive samples （7.8%） and 17 enteric adenovirus positive samples （1.9%）. The overall positive rate of four viruses was significantly higher in urban area than in rural area, but the positive rate of rotavirus was higher in males than in females and in younger age group than in older age group. G9P[8] was the major genotype of group A rotavirus, there were two seasonal infection peaks in autumn and spring. Norovirus Ⅱ was the predominant type of calicivirus and the infection peak was in spring. Viral diarrhea cases were distributed in different age groups, mainly in age groups 0-12 months （rotavirus） and 3-5 years （calicivirus）. The main clinical symptoms included fever, diarrhea and vomiting. The etiological characteristics differed with gender and area. Conclusions The infection rate of diarrheal viruses was higher in young children 〈5 years old in disease surveillance areas. The epidemiological and clinical features varied with the type of pathogen.