杭州市儿童腺病毒感染的流行病学与病原学特征

Epidemiological and pathogenic characteristics of adenovirus infection in children of Hangzhou city

目的了解杭州市儿童腺病毒(Adenovirus,Adv)感染流行病学和病原学特征。方法收集2011年6月-2014年5月杭州市儿童急性上呼吸道感染哨点监测病例和暴发疫情信息,采集病例标本进行Adv检测和基因型鉴定,描述性分析Adv感染特征。结果儿童急性上呼吸道感染监测病例的Adv检出阳性率为8.53%(32/375),其中城区、农村分别为11.02%、3.85%(χ^2=5.60,P=0.02),男、女性分别为7.17%、9.87%(χ^2=0.71,P=0.40),0-3、4-7、8-11、12-14岁分别为6.54%、13.56%、15.62%、11.11%(χ^2=4.43,P=0.22)。Adv感染临床表现包括急性咽喉炎、咽结膜热、急性呼吸道感染、肺炎等。共报告6起Adv感染暴发疫情,包括Adv-Ⅱ型5起、Adv-Ⅱ型1起;其中2起Adv-III型暴发中20株毒株与GenBank中Adv-III型毒株hexcon基因的核苷酸同源性为98.7%-100%。结论Adv为杭州市儿童急性上呼吸道感染的重要致病原,以Adv-III型为主。建议加强儿童Adv感染流行病学和病原学监测、暴发疫情控制以及Adv疫苗的研发。

Objective To determine epidemiological and pathogenic characteristics of adenovirus(Adv)infection in children of Hangzhou city.Methods We obtained data on sentinel surveillance cases and outbreaks of acute upper respiratory inf ection(URI)in children during June 2011-May 2014.We collected specimens f rom cases f or Adv detection and genotyping,and conducted a descriptive analysis.Results The positivity rate of Adv detection was 8.53%(32/375)among children with acute URIs,with positivity rates of 11.02%in urban areas and 3.85%in rural areas(χ^2=5.60,P=0.02);7.17%in males and 9.87%in females(χ^2=0.71,P=0.400);and 6.54%,13.56%,15.62%,and 11.11%(χ^2=4.43,P=0.22)for 0-3,4-7,8-11,and 12-14 year olds,respectively.Clinical manifestations of Adv infection included acute laryngopharyngitis,pharyngoconjunctival fever,acute respiratory infection,and pneumonia.Six Adv infection outbreaks were identified;five were caused by Adv-III,and one by Adv-IV.Twenty strains f rom two of AdvIII infection outbreaks showed a homology of 98.7%-100%in nucleotide sequences of hexcon gens compared with Adv-III strains f rom the GenBank.Conclusions Adv was a predominant pathogen of acute URIs in Hangzhou children.We suggest enhancing epidemiological and pathogenic surveillance of childhood Adv infection,enhancing outbreak control,and conducting Adv vaccine research.