甘肃省兰州市某区发热出疹性疾病血清学与病原学监测分析

Serologic and etiologic surveillance of rash and fever illness in a district of Lanzhou city,Gansu province

目的了解甘肃省兰州地区儿童发热出疹性疾病（Rash and fever illness,RFI）血清学和病原学特征,为麻疹控制提供依据。方法选择2016年10月1日-2017年9月30日兰州市某区7家医院就诊的0-14岁RFI患儿,对患儿血清标本采用酶联免疫吸附试验检测麻疹病毒IgM抗体,对患儿咽拭子标本采用PCR-荧光探针法检测麻疹病毒基因。结果兰州某区RFI患儿血清麻疹Ig M阳性率为11.6%（77/662）,本地、流动人口分别为10.9%（60/552）、15.5%（17/110）;咽拭子标本麻疹病毒H1a基因型检出率为18.9%（61/323）,本地人口、流动人口分别为18.5%（50/271）、21.1%（11/52）。本地、流动人口病例中有麻疹疫苗免疫史分别占100%（476/476）、71.6%（78/109）。结论兰州地区RFI病例麻疹实验室确诊率流动人口高于本地人口,应加强流动人口疫苗接种工作。

Objective To determine serologic and etiologic characteristics of rash and fever illness（ RFI）cases in a district of Lanzhou,and to provide evidence for strengthening measles and rubella control.Methods We selected 0-14 year old RFI cases from 7 hospitals in a district in Lanzhou that were reported between October 1,2016 and September 30,2017. We collected serum specimens for measles Ig M antibody detection by enzyme-linked immunosorbent assay（ ELISA）,and throat swabs for detection of measles virus genes by quantitative PCR fluorescence. Results Among all RFI cases,the measles Ig M sero-positivity rate was 11. 6%（ 77/662）; among local cases sero-positivity was 10. 9%（ 60/552）,and among migrant cases,sero-positivity was 15. 5%（ 17/110）. Among all RFI cases for which we had throat swabs,H1 a measles virus genotype was isolated from 18. 9%（ 61/323）; among local cases H1 a genotype was isolated from 18. 5%（ 50/271）,and among migrant cases,H1 a genotype was isolated from21. 1%（ 11/52）. All（ 476/476） local cases and 71. 6%（ 78/109） of migrant cases had received measles vaccine. Conclusions The proportion of lab-confirmed measles was higher among migrant RFI cases than among local RFI cases. Vaccination efforts for migrant children should be strengthened.