昆明市儿童医院1998～2001年轮状病毒哨点监测分析

目的 了解昆明市轮状病毒腹泻的流行状况。方法 以昆明市儿童医院为哨点监测,监测对象为5岁以下腹泻住院患儿,收集患儿的临床资料和粪便标本进行轮状病毒的检测和分型。病毒检测用聚丙烯酰胺凝胶电泳(PAGE)和酶联免疫吸附试验(ELISA),毒株分型用ELISA和/或反转录-聚合酶链反应(RT-PCR)。结果 3年监测中共收集466份腹泻患儿的粪便标本,轮状病毒的检出率为52.8％(246/466)。轮状病毒感染97％发生于2岁以下儿童。感染有明显的季节性,10～12月份是流行季节。对204份轮状病毒阳性标本进行G分型,G1型为流行优势株,占47.5％,其次为G2型(17.6％)、G3型(15.7％)G9型(4.9％)和G4型(1.0％)。P基因型以P[4]、P[8]和P[6]型为常见。最常见的P-G组合型是P[4]G2,占34.1％(14/41),其次是P[8]G1和P[6]G9,分别占29.3％(12/41)和12.2％(5/41),还有其他7种不常见的P-G组合的毒株类型。结论 轮状病毒是昆明地区儿童腹泻住院的主要病原,毒株呈现型的多样性,应该开发和应用轮状病毒疫苗预防控制其流行。     

三个监测点医院2001-2004年婴幼儿轮状病毒腹泻监测

目的 了解3个监测点医院2001年8月至2004年7月住院的5岁以下婴幼儿轮状病毒腹泻流行状况。方法 以医院为基础的哨点监测,监测对象为5岁以下腹泻住院患儿。收集患儿的临床资料和粪便标本并进行轮状病毒检测和分型。结果 共检测3121份腹泻患儿的粪便标本,轮状病毒检出率为51%。94%的轮状病毒腹泻发生在2岁以下儿童。G3型为流行优势株,占69．9%,其次为G1型6．6%、G2型2．9%、G9型2．2%、G4型0．3%。P[8]型为最常见的P基因型。最常见的P-G组合型是P[8]G3,占64．0%,还有其他7种不常见的P-G组合的毒株类型。结论 轮状病毒是3个监测点医院住院腹泻患儿的主要病原,P[8]G3型为主要流行株。     

北京友谊医院1998～2001年轮状病毒哨点监测分析

目的 了解5岁以下儿童中以医院为基础的轮状病毒流行情况。方法 按WHO轮状病毒监测的通用方法(CID-98)进行，轮状病毒检测采用聚丙烯酰胺凝胶电泳／酶联免疫吸附试验(ELISA)。毒株分型用ELISA／逆转录聚合酶链反应。结果从1998年4月至2001年3月收集的484份腹泻患儿粪便标本中，检出阳性标本：123份，总的轮状病毒感染检出率为25．4％，住院和门诊患儿检出率分别是31．6％和27．3％，而在轮状病毒流行季节，则可以引起高达46．2％急性腹泻住院率。腹泻患儿发病呈现两个明显的季节高峰：一个由细菌性痢疾引起的夏季(6～9月)发病高峰，另一个是轮状病毒感染腹泻造成的秋冬季(10～12月)发病高峰。轮状病毒感染96．8％发生于3岁以下幼儿，主要在6～11月龄(38．2％)和1～2岁(28．5％)年龄组，轮状病毒感染率在6～35月龄年龄段最高。流行的轮状病毒G血清型依次为G1(55．3％)、G2(26．8％)、G3(9．8％)和G4(0．8％)，没有发现G9型，10份(8．1％)标本未能分型，混合感染(0．8％)罕见。结论 轮状病毒腹泻是北京市儿童的重要传染病，开发应用安全有效的轮状病毒疫苗将对减轻轮状病毒疾病负担有重要作用。     

苏州市婴幼儿轮状病毒腹泻分子流行病学研究

目的 研究苏州市5岁以下婴幼儿轮状病毒腹泻分子流行病学特征。方法 对2001年9月～2002年8月期间在苏州大学附属儿童医院就诊的5岁以下腹泻患儿进行调查。收集腹泻患儿粪便标本检测轮状病毒并对轮状病毒阳性标本用ELISA、PCR法进行分型研究。结果 共检测标本775份，轮状病毒阳性274份，检出率35．35％；血清分型发现，轮状病毒腹泻G分型以G3(40．15％)和G1(28．42％)为主要流行株，基因P分型结果以P[4](39．68％)为主，尚发现较多不常见G／P组合和未分型病毒株。结论 苏州市婴幼儿轮状病毒腹泻，以G3和P[4]最多见，但有较多未分型病毒株，应继续进行轮状病毒腹泻的监测。     

2007～2008年广西罗城县轮状病毒腹泻哨点监测分析

目的了解广西轮状病毒腹泻流行状况和特点。方法以广西罗城县为监测哨点,监测对象为5岁以下腹泻住院患儿,全年收集患儿的粪便标本进行轮状病毒检测和分型,使用酶联免疫吸附试验(ELISA)进行病毒检测,反转录-聚合酶链反应(RT-PCR)进行病毒分型。结果2年共收集607份腹泻患儿粪便标本,轮状病毒检出率为54.29%。轮状病毒腹泻的主要流行季节为11月至次年2月,2岁以下患儿占全部患儿总数的96.11%。G1型为主要流行优势株,占64.54%,其次是G9型占12.77%。P基因型以P[8]为最常见型,P[6]次之;P[8]G1成为2007～2008年的主要流行株,还有其他7种不常见的P-G组合的毒株类型。结论轮状病毒是广西罗城县婴幼儿腹泻住院的主要病原,毒株流行型别显示一定的多样性和规律性,提示有必要在广西长期开展轮状病毒监测。     

福州地区2009-2014年腹泻儿童轮状病毒特征

目的 了解轮状病毒在福州地区腹泻儿童中的流行情况.方法 收集2009-2014年5岁以下腹泻住院儿童粪便标本,用ELISA法检测轮状病毒抗原,RT-PCR法确定基因型别.对G9轮状病毒阳性标本的VP7基因全长测序及进化分析.结果 福州地区腹泻儿童轮状病毒高峰期在10～12月,呈单峰流行态势.G9轮状病毒在2011年后成为福州地区优势流行型别,毒株VP7基因核苷酸序列相似性92.5％～100％,毒株间有较高的同源性,进化分析都属于G9第3亚型.结论 G9轮状病毒在福州地区流行强度逐渐加强,目前已成为优势流行型别.毒株同源性高,属G9型3亚型.     

农村婴幼儿病毒性腹泻流行病学调查

目的为预防控制婴幼儿病毒性腹泻的流行提供病原学和流行病学依据。方法以河北省卢龙县医院和妇幼保健院因腹泻住院治疗的患儿为监测对象，采用流行病学调查方法对腹泻病患儿进行检测调查。结果1236份粪便样本轮状病毒阳性率为46％；398份轮状病毒阴性样本中杯状病毒阳性率为31．6％；2种病毒腹泻感染率以12月龄的患儿所占比例最高．分别为39．3％和27．4％，其中轮状病毒9月龄患儿感染率为26．1％．6月龄为14．4％；而杯状病毒6，9，3月龄患儿感染率分别为25．6％，17．9％和16．2％。轮状病毒和杯状病毒感染发病月份基本一致，主要集中在当年12月至次年2月，分别占全年病例的86％和65％。轮状病毒毒株鉴定结果：G3型（45％）最常见，其次为G1型（35％），Q型（8％），G4型（3％），G9型（0．6％），混合感染（1％），未分型（8％）；杯状病毒经DNA测序均属于诺瓦克病毒（NLV）GⅡ遗传组。流行株为NLVGⅡ-4，GⅡ-7和GⅡ-3。结论婴幼儿病毒性腹泻的病原主要是轮状病毒，其次是杯状病毒。     

苏州儿童医院2001—2002年婴幼儿轮状病毒腹泻的分子流行病学研究

目的 了解苏州地区婴幼儿轮状病毒腹泻的分子流行病学特征。方法 采用酶联免疫吸附试验，巢式聚合酶链反应对该院2001－2002年收集的婴幼儿腹泻标本进行轮状病毒检测及血清型研究，同时填写统一制定的调查表，分析流行特征。结果 775份婴幼儿腹泻标本轮状病毒阳性率为35．35％，血清型分型发现G3型为流行优势株，占49．0％；其次为G1型占32．9％，再次为G2，G4；未定型占12．0％；G9型有3例，为1a以内患儿，G1和G3全年季节性分布与轮状病毒阳性的分布一致。结论 苏州地区2001－2002年婴幼儿轮状病毒腹泻的主要血清型为G3和G1，G3为优势毒株。     

2012年广东省5岁以下儿童腹泻病 流行特征及重点病原监测

目的探讨广东省<5岁儿童腹泻病流行特征和重点病原监测。方法2012年在 广东省21个地市选择64家医院开展腹泻症状监测,其中14家医院采集<5岁儿童腹泻病粪便标 本,开展霍乱弧菌、志贺菌分离培养及轮状病毒、诺如病毒ELISA、PCR检测。分析52周腹泻病症 状监测数据和1932例<5岁儿童腹泻病重点病原监测结果。结果2012年广东省<5岁儿童腹 泻就诊病例占监测门诊就诊总人次数的O．8％,占监测门诊全年龄组腹泻病例就诊总人次数的 63．5％;以医院为基础报告<5岁儿童感染性腹泻病年发病率为1454．5/10万。全年采集<5岁儿 童腹泻病标本1932份,检测霍乱弧菌均为阴性,宋内志贺菌1例阳性,轮状病毒阳性率为14．1％ (273/1932),诺如病毒阳性率为16．9％(326/1932),诺如病毒和轮状病毒合并感染24例(1．2％)。 112份轮状病毒和90份诺如病毒阳性标本测序表明,轮状病毒主要以G1[P8]为主(33．9％),其 次为G9[P8](25．9％)、G2[P4](12．5％)、G3[P8](9．8％);诺如病毒以GII．4型为主(76．7％),并检 出5份G I型和16份GⅡ其他型/变异株,除6月(未开展测序工作)和12月外其余各月均检出 GⅡ．4/2006b型(占50．0％),GII。4/Sydney 2012变异株于8月首次检出并在12月成为流行优势 株。结论<5岁儿童是广东省腹泻病高危人群,感染的轮状病毒和诺如病毒具有基因多样性。     

长春市2005~2013年小儿轮状病毒腹泻流行病学研究

目的:了解长春市小儿轮状病毒腹泻流行病学特征。方法:在长春市儿童医院收集5岁以下住院腹泻患儿粪便标本和临床资料,对粪便标本采用ELISA方法进行轮状病毒检测,用反转录PCR方法进行G血清型和P基因型分析。结果:长春市2005~2013年小儿腹泻轮状病毒阳性检出率为53.33%(2098/3934),2005~2010年逐年下降,2011年开始上升;轮状病毒性腹泻每年10月到次年2月为感染高发季节;轮状病毒感染以G3型为主(51.83%)是流行优势株,但G3型呈下降趋势,G9型有上升趋势;P血清型以P[8]型为主;发病年龄97.54%集中在0~24月龄婴幼儿,高发年龄段为7~12月龄婴儿,男∶女为1.83∶1;主要临床表现是腹泻、呕吐和发热。结论:轮状病毒是长春市小儿腹泻的主要病原,G分类是G3型,P分类是P[8]型,并且呈现超常多样性。长期监测轮状病毒性腹泻病原变化对于预防病毒性腹泻和疫苗研发有重要意义。     

兰州地区2004-2005年度婴幼儿病毒性腹泻的病原学研究

目的了解兰州地区主要四种腹泻病毒的流行病学特点.方法收集兰州大学第一医院儿科2004年7月至2005年6月5岁以下全部住院腹泻患儿400例的粪便标本,分别采用Dako公司酶免疫试剂盒检测轮状病毒、星状病毒、腺病毒,杯状病毒检测采用酶免疫法和逆转录-聚合酶链反应（RT-PCR）法.对轮状病毒、星状病毒阳性标本用RT-PCR进行毒株分型鉴定.结果400份标本中四种病毒检测阳性率依次为轮状病毒47.3%、杯状病毒15.5%、星状病毒9.5%、腺病毒7.5%.其中有混合感染的病例数占13.5%.轮状病毒毒株G血清型分型结果为G2（34.4%）、G3（32.8%）、G1（1.1%）、不同型混合感染（5.8%）、未能分型（25.9%）,P基因型分型结果为P[4]（45%）、P[8]（22.1%）、未能分型（32.9%）.G型与P型组合P[4]G2（43.6%）、P[8]G3（25.6%）,P[4]G3（13.8%）、P[8]G2（3.2%）、P[4]G1和P[8]G1各1例.星状病毒血清分型结果为1型（57.8%）、3型（2.6%）、8型（2.6%）、未能分型（36.8%）.病毒性腹泻的高发季节轮状病毒最为明显为10-12月份.发病年龄主要为2岁以下婴幼儿,轮状病毒的高发年龄是6-23月龄.结论兰州地区婴幼儿病毒性腹泻的病原复杂,轮状病毒仍是最主要病原,该年度轮状病毒的主要流行株为P[4]G2,与往年明显不同,病原混合感染比例较大,值得重视.     

安徽省婴幼儿腹泻轮状病毒G/P分型分析

目的了解安徽省婴幼儿腹泻轮状病毒的基因型别分布特点。方法对2011年1～12月收集的5岁以下住院婴幼儿腹泻粪便标本307份,采用酶联免疫吸附试验(ELISA)检测轮状病毒抗原,阳性标本运用逆转录聚合酶链式反应(RT-PCR)进行G型和P型分型。结果 307份粪便标本中轮状病毒阳性率为15.64%(48/307);G3型为优势株,占47.91%(23/48),G9型占27.08%(13/48),G1型占16.67%(8/48),混合G型感染占14.58%(7/48),G2型占6.25%(3/48),G4型占2.08%(1/48);P基因型中最常见为P[8],占62.67%(32/48),P[4]占8.33%(4/48);G3P[8]优势组合占47.91%。结论引起安徽地区婴幼儿腹泻的轮状病毒G3P[8]是主要优势流行株,G9型为次之的优势株且存在混合G型感染。     

Impact of rotavirus vaccine introduction and genotypic characteristics of rotavirus strains in children less than 5 years of age with gastroenteritis in Ethiopia: 2011–2016

IntroductionA monovalent rotavirus vaccine was introduced in the Ethiopian Expanded Program on Immunization from November 2013. We compared impact of rotavirus vaccine introduction on rotavirus associated acute diarrhea hospitalizations and genotypic characteristics of rotavirus strains pre-and post-vaccine introduction.MethodsSentinel surveillance for diarrhea among children <5 years of age was conducted at 3 hospitals in Addis Ababa, Ethiopia from 2011 to 2017. Stool specimens were collected from enrolled children and tested using an antigen capture enzyme immunoassay. Rotavirus positive samples (156 from pre- and 141 from post-vaccination periods) were further characterized by rotavirus genotyping methods to identify the predominant G and P types circulating during the surveillance era.ResultsA total of 788 children were enrolled during the pre- (July 2011-June 2013) and 815 children during the post-vaccination (July 2014-June 2017) periods. The proportion of diarrhea hospitalizations due to rotavirus among children <5 years of age declined by 17% from 24% (188/788) in the pre-vaccine period and to 20% (161/185) in post-vaccine introduction era. Similarly, a reduction of 18% in proportion of diarrhea hospitalizations due to rotavirus in children <12 months of age in the post (27%) vs pre-vaccine (33%) periods was observed. Seasonal peaks of rotavirus declined following rotavirus vaccine introduction. The most prevalent circulating strains were G12P[8] in 2011 (36%) and in 2012 (27%), G2P[4] (35%) in 2013, G9P[8] (19%) in 2014, G3P[6] and G2P[4] (19% each) in 2015, and G3P[8] (29%) in 2016.DiscussionFollowing rotavirus vaccine introduction in Ethiopia, a reduction in rotavirus associated hospitalizations was seen in all age groups with the greatest burden in children <12 months of age. A wide variety of rotavirus strains circulated in the pre- and post-vaccine introduction periods.     

Impact of rotavirus vaccine on all-cause diarrhea and rotavirus hospitalizations in Madagascar

BackgroundRotavirus vaccine was introduced into the Extended Program on Immunization in Madagascar in May 2014. We analyzed trends in prevalence of all cause diarrhea and rotavirus hospitalization in children <5 years of age before and after vaccine introduction and assessed trend of circulating rotavirus genotypes at Centre Hospitalier Universitaire Mère Enfant Tsaralalàna (CHU MET).MethodsFrom January 2010 to December 2016, we reviewed the admission logbook to observe the rate of hospitalization caused by gastroenteritis among 19619 children <5 years of age admitted at the hospital. In June 2013–December 2016, active rotavirus surveillance was also conducted at CHUMET with support from WHO. Rotavirus antigen was detected by EIA from stool specimen of children who are eligible for rotavirus gastroenteritis surveillance at sentinel site laboratory and rotavirus positive specimens were further genotyped at Regional Reference Laboratory by RT-PCR.ResultsDiarrhea hospitalizations decreased after rotavirus vaccine introduction. The median proportion of annual hospitalizations due to diarrhea was 26% (range: 31–22%) before vaccine introduction; the proportion was 25% the year of vaccine introduction, 17% in 2015 and 16% in 2016. Rotavirus positivity paralleled patterns observed in diarrhea. Before vaccine introduction, 56% of stool specimens tested positive for rotavirus; the percent positive was 13% in 2015, 12% in 2016. Diverse genotypes were detected in the pre-vaccine period; the most common were G3P[8] (n = 53; 66%), G2P[4] (n = 12; 15%), and G1P[8] (n = 11; 14%). 6 distinct genotypes were found in 2015; the most common genotype was G2P[4] (n = 10; 67%), the remaining, 5, G12[P8], G3[P8], G1G3[P4], G3G12[P4][P8] and G1G3[NT] had one positive specimen each.ConclusionsFollowing rotavirus vaccine introduction all-cause diarrhea and rotavirus-specific hospitalizations declined dramatically. The most common genotypes detected in the pre-vaccine period were G3P[8] and G2P[4] in 2015, the post vaccine period.     

Update on the disease burden and circulating strains of rotavirus in China: A systematic review and meta-analysis

Background

Rotavirus is the most common cause of severe diarrhea in children, and most associated deaths occur in developing countries. Two new internationally licensed vaccines are expected to be launched in the near future in China. We performed a systematic review and meta-analysis of rotavirus studies to update information on the burden of rotavirus disease in China.

Materials and methods

Eligible studies published before 2011 were identified using PubMed/Medline, Embase, Cochrane Library, LILACS, WHOLIS, and two Chinese literature databases, CNKI, and WANFANG. Arc-sine transformations and the DerSimonian–Laird random-effects or fixed-effects models were used for meta-analysis.

Results

A total of 211 studies were included in this review, of which 63 (29.9%) were inpatient studies, 26 (12.3%) were outpatient, 122 (57.8%) were combined. Community subjects were investigated in two combined studies. Rates of gastroenteritis caused by rotavirus in inpatients, outpatients, and community children were 42.6%, 32.5% and 9.3%, respectively. The most common G type was G3 (39.3%), followed by G1 (30.3%), G2 (7.2%), and G9 (3.3%). The most common P types were P[8] (50.2%), P[4] (18.2%), and P[6] (7.2%). The most prevalent G-P combinations were G3P[8] (32.1%), G1P[8] (23.0%), and G2P[4] (7.9%).

Conclusion

Rotavirus is an important cause of both severe and mild diarrheal disease in children <5 years of age in China; G3P[8] is the most prevalent strain. The introduction of an effective rotavirus vaccine to Chinese pediatric immunization programs is necessary.     

Rotavirus strain distribution in Ghana pre- and post- rotavirus vaccine introduction

BackgroundGhana introduced the monovalent rotavirus vaccine (Rotarix) into its national paediatric vaccination programme in May2012. Vaccine introduction was initiated nationwide and achieved >85% coverage within a few months. Rotavirus strain distribution pre- and post-RV vaccine introduction is reported.MethodsStool samples were collected from diarrhoeic children <5 years of age hospitalized between 2009 and 2016 at sentinel sites across Ghana and analyzed for the presence of group A rotavirus by enzyme immunoassay. Rotavirus strains were characterized by RT-PCR and sequencing.ResultsA total of 1363 rotavirus EIA-positive samples were subjected to molecular characterization. These were made up of 823 (60.4%) and 540 (39.6%) samples from the pre- and post-vaccine periods respectively. Rotavirus VP7 genotypes G1, G2 and G3, and VP4 genotypes P[6] and P[8] constituted more than 65% of circulating G and P types in the pre–vaccine period. The common strains detected were G1P[8] (20%), G3P[6] (9.2%) and G2P[6] (4.9%).During the post-vaccine period, G12, G1 and G10 genotypes, constituted more than 65% of the VP7 genotypes whilst P[6] and P[8] made up more than 75% of the VP4 genotypes. The predominant circulating strains were G12P[8] (26%), G10P[6] (10%) G3P[6] (8.1%) and G1P[8] (8.0%). We also observed the emergence of the unusual rotavirus strain G9P[4] during this period.ConclusionRotavirus G1P[8], the major strain in circulation during the pre-vaccination era, was replaced by G12P[8] as the most predominant strain after vaccine introduction. This strain replacement could be temporary and unrelated to vaccine introduction since an increase in G12 was observed in countries yet to introduce the rotavirus vaccine in West Africa. A continuous surveillance programme in the post-vaccine era is necessary for the monitoring of circulating rotavirus strains and the detection of unusual/emerging genotypes.