河北省卢龙县1999～2001年婴幼儿杯状病毒腹泻流行病学研究

Epidemiological study of human caliciviruses among children with acute diarrhea in Lulong county,1999-2001

目的 研究河北省卢龙县 5岁以下婴幼儿杯状病毒腹泻的流行特点。方法 应用酶联免疫吸附试验 (ELISA)和逆转录 聚合酶链反应 (RT PCR)方法检测人类杯状病毒 (HuCVs)。部分阳性标本的PCR产物经克隆测序 ,结合参考毒株相应的核苷酸序列进行进化分析。利用住院腹泻患者粪便样本中HuCVs的检出率 ,估计HuCVs腹泻住院率。结果 HuCVs检出率为 31.6 % ,住院患者HuCVs阳性率为 17.5 % ,主要分布在 3～ 17月龄婴幼儿 ,发病主要集中在冬季。 11株测序病毒之间的核苷酸序列同源性为 5 5 .1%～ 10 0 % ,均属于诺瓦克病毒 (NLV)GⅡ遗传组。卢龙县 2 0 0 0年HuCVs流行株为NLVGⅡ 4和GⅡ 7,2 0 0 1年为NLVGⅡ 3和GⅡ 7。初步估计HuCVs腹泻患者住院率为 3.6‰。结论 河北省卢龙县婴幼儿中存在不同基因型杯状病毒感染 ,以NLVGⅡ组毒株为主 ,其疾病负担仅次于轮状病毒。

Objective To investigate the epidemiological characteristus of human caliciviruses (HuCVs) among children under 5 years of age with acute diarrhea and to estimate the disease burden in Lulong county. Methods HuCVs were detected by enzyme linked immunosorbent assay (ELISA) and reverse transcription-polymerase chain reaction(RT-PCR). Some PCR amplicons were cloned and sequenced. Phylogenetic tree was constructed for strain characterization. The rate of HuCVs-attributed hospitalization was estimated according to the positive rate of HuCVs detection in fecal specimens collected from hospitalized diarrhea patients. Results Between July 1999 and June 2001, 708 fecal specimens were collected, of which 393 rotavirus-negative and 5 rotavirus-positive specimens were detected for HuCVs. Thirty -one point six percertage of fecal specimens from patients with diarrhea was HuCVs positive. Among inpatients, HuCVs positive rate was 17.5 %. HuCVs detection was mainly distributed in 3- 17 mouth-old children, in winter. All 11 strains belonged to NLV GⅡ in which 6 strains GⅡ-3, 2 strains GⅡ-4 and 3 strains GⅡ-7, and they shared 55.1%- 100% nucleotide identity. NLV GⅡ-4 and GⅡ-7 were identified in 2000, while NLV GⅡ-3 and GⅡ-7 in 2001. The preliminary estimate of HuCVs-attributed hospitalization rate was 3.6 ‰. Conclusion Human caliciviruses with different genotypes circulated among children in Lulong county with GⅡ NLVs were the prevalent strains. The disease burden of HuCVs was second to rotavirus.