2018-2019年上海市普陀区16起聚集性呕吐腹泻疫情中诺如病毒的流行与分析

Prevalence and analysis of norovirus in 16 clusters of vomiting and diarrhea outbreaks in Putuo District of Shanghai from 2018 to 2019

目的了解上海市普陀区16起聚集性呕吐腹泻疫情中诺如病毒的基因分型和流行特征,为辖区和全市诺如病毒引起的聚集性呕吐腹泻疫情的处置与防控提供技术支撑和数据参考。方法收集2018-2019年上海市普陀区16起聚集性呕吐腹泻疫情所涉及人群的肛拭标本136份。采用实时荧光聚合酶链反应方法检测诺如病毒核酸,典型病例阳性标本采用实时荧光聚合酶链反应扩增聚合酶-衣壳蛋白连接区并进行测序,通过生物信息工具进行基因分型和构建进化树。结果136份标本中诺如病毒GⅡ组核酸阳性62份(45.59%),GⅠ组核酸阳性0份。42份诺如病毒测序成功,通过序列比对分析获得4种基因型别。16起聚集性呕吐腹泻疫情中9起疫情是GⅡ.P16-GⅡ.2型(56.25%),2起疫情是GⅡ.P7-GⅡ.6型(12.50%),2起疫情是GⅡ.P12-GⅡ.3型(12.50%),3起疫情是GⅡ.Pe-GⅡ.4型(18.75%)。结论诺如病毒是引起2018-2019年上海市普陀区聚集性呕吐腹泻疫情的重要病原体,以GⅡ组为主,有多种基因型别,其中GⅡ.P16-GⅡ.2型为主要流行株。

Objective To understand the genotyping and epidemiological characteristics of norovirus in 16 clusters of vomiting and diarrhea in Putuo District of Shanghai,and to provide technical support and data reference for the treatment and prevention of clusters of vomiting and diarrhea caused by norovirus in the district and the whole city.Methods A total of 136 anal swab samples were collected from people involved in 16 clusters of vomiting and diarrhea outbreaks in Putuo District of Shanghai from 2018 to 2019.The nucleic acid of norovirus was detected by real-time fluorescence polymerase chain reaction.The polymerase-capsid protein link region was amplified by real-time fluorescence polymerase chain reaction and sequenced in the positive samples of typical cases.Genotyping and phylogenetic tree were constructed by bioinformatics tools.Results Among the 136 specimens,62(45.59%)were positive for norovirus GⅡnucleic acid,and zero was positive for norovirus GI nucleic acid.42 noroviruses were successfully sequenced,and four genotypes were obtained by sequence alignment analysis.Among the 16 clusters of vomiting and diarrhea outbreaks,nine were GⅡ.P16-GⅡ.2(56.25%),two were GⅡ.P7-GⅡ.6(12.50%),two were GⅡ.P12-GⅡ.3(12.50%),and three were GⅡ.Pe-GⅡ.4(18.75%).Conclusion Norovirus is an important pathogen causing clustered vomiting and diarrhea in Putuo District of Shanghai from 2018 to 2019.It is mainly GⅡgroup and has a variety of genotypes,among which GⅡ.P16-GⅡ.2 is the main epidemic strain.