闵行区腹泻病监测人群中诺如病毒感染分析

Analysis of Norovirus Infection Among Diarrhoea Surveillance Population in Minhang District

目的通过对闵行区腹泻病监测医院的腹泻病监测,了解闵行区人群诺如病毒腹泻病的流行病学特点。方法于2014-2016年,按一定的抽样间隔随机选取上海市闵行区2家监测点医院肠道门诊的腹泻病病例开展调查采样,同时采用real-time PCR方法对采集的粪便标本进行诺如病毒检测,并通过基因测序进一步对诺如病毒阳性毒株进行分型分析。结果共监测腹泻病病例11234例,其中实验室采样803例,检出诺如病毒阳性病例207例,其中31例存在混合感染;就诊病例数呈现季节性波动,7~8月份、12月份~次年1、2月份为腹泻病患者就诊的2个高峰;不同年龄段和性别诺如病毒检测阳性率比较,差异无统计学意义(P>0.05);基因分型共检测11个基因型(GⅡ.2、GⅡ.3、GⅡ.4、GⅡ.5、GⅡ.6、GⅡ.7、GⅡ.8、GⅡ.13、GⅡ.14、GⅡ.17、GⅡ.21),优势型为GⅡ.4,但是GⅡ.17正逐渐取得流行优势地位。结论诺如病毒作为本地区病毒性腹泻病感染的优势病原,不仅有明显的季节性流行特征,且具有常年流行趋势;以GⅡ.4基因型为优势基因型,且具有丰富的基因型。

Objective To understand the epidemiological characteristics of norovirus diarrhea in Minhang District by monitoring diarrhea in Minhang District Diarrhea Surveillance Hospital.Methods From 2014 to 2016,diarrhea cases were randomly selected from intestinal outpatient of two monitoring hospitals in Minhang District of Shanghai according to a certain sampling interval.At the same time,real-time PCR method was used to detect norovirus in fecal samples,and the genotype of norovirus positive strains was further analyzed by gene sequencing.Results A total of 11234 diarrhea cases were monitored,including 803 laboratory samples,and 207 norovirus positive cases were detected,including 31 cases with mixed infection.The number of cases showed seasonal fluctuations,and July to August,December to January and February of the next year were the two peaks of diarrhea patients.There was no significant difference in the positive rate of norovirus detection between different age groups and genders(P>0.05).A total of 11 genotypes(GⅡ.2,GⅡ.3,GⅡ.4,GⅡ.5,GⅡ.6,GⅡ.7,GⅡ.8,GⅡ.13,GⅡ.14,GⅡ.17,GⅡ.21)were detected by genotyping.The dominant genotype was GⅡ.4,but GⅡ.17 was gradually gaining the dominant position.Conclusion As the dominant pathogen of viral diarrhea in the region,norovirus not only has obvious seasonal epidemic characteristics,but also has an annual epidemic trend.GⅡ.4 genotype was the dominant genotype,and it had abundant genotypes.