长春市儿童医院1998～2001年轮状病毒哨点监测分析

Surveillance finding on rotavirus in Changchun children's hospital during July 1998 -June 2001

目的 为在中国开发和应用轮状病毒疫苗提供流行病学背景资料。方法 以医院为基础的哨点监测 ,在长春市儿童医院 5岁以下腹泻患儿中进行 ,收集患儿临床资料和粪便标本 ,轮状病毒检测用聚丙烯酰胺凝胶电泳 (PAGE)和 或酶联免疫吸附试验 (ELISA) ,毒株分型用ELISA和 或逆转录 聚合酶链反应 (RT PCR)。所有资料录入计算机进行数据分析。结果 3年监测中共调查 2 3 4 3例腹泻患儿 ,收集便样 12 11份 ,轮状病毒检出率门诊患儿和住院患儿分别为 3 1.0 %和 52 .9%。轮状病毒感染 95.0 %发生于 2岁以下儿童。每年寒冷季节流行 (11月到次年 3月 )。流行的轮状病毒G血清型依次为G1(82 .4% )、G2 (5.0 % )、G3 (3 .3 % )和G 4(0 .9% ) ,P基因型以P[8]和P[4]为常见。共检出 9种P～G结合的毒株 ,其中世界常见的 4种流行株占 75.6%。结论 轮状病毒流行毒株呈现超常多样性 。

ObjectiveTo establish baseline patterns of rotavirus diarrhea and to describe its epidemiologic features in Changchun city , prior to rotavirus vaccine immunization. MethodsHospital-based surveillance was conducted among children under 5 years old with acute diarrhea in Changchun Children's Hospital. Fecal samples were determined to identify rotavirus by PAGE and/or ELISA. G ser otypes of rotavirus were identified by ELISA and/or nested RT-PCR. P genotypi ng were carried out by RT-PCR. All data were computerized and analysed by“Gene ric Manual on Rotavirus Surveillance” set by CDC in the USA. ResultsIn total, 2 343 diarrhea cases were screened and 1 211 fecal samples were collected. Rotavirus was detected in 31.0 % among outpatients and 52.9% in inpatients. During the peak of the season (Novem ber through March), 58.6 % of diarrhea was caused by rotavirus among inpatien ts. 95.0 % of rotavirus diarrhea cases occurred among children aged <2 years . The predominant strain was serotype G1 ( 82.4 %), followed by G2 ( 5.0 %), G3 ( 3.3 %), G4 ( 0.9 %). P genotyping showed that P [8] and P [4] were the most common ones. Nine different P-G combinations were identified, with four worldwidely commonly seen strains (P [8] G1, P [4] G2, P [8 ] G3, and P [8] G4), accounted for 75.6 % of the total, together with u ncommon strains including the novel types P [4] G4 and P [8] G2,which hi ghlightied the extraordinary diversity of rotaviruses circulating in China.ConclusionRotavirus is the major cause of severe child d iarrhea in Changchun. Developing a rotavirus vaccine for prevention of severe di sease and reduction of treatment costs seemed to be necessary.