上海市闵行区29起水痘爆发疫情分析及水痘-带状疱疹病毒流行株基因分型研究

目的了解上海市闵行区29起水痘爆发疫情的流行病学特征,以及水痘-带状疱疹病毒（Varicella-zoster Virus,VZV）流行株的基因型别。方法根据法定传染病报告系统和疾病监测点进行实时流行病学调查,收集数据并统计分析;同时对部分临床诊断水痘病例采集疱疹液标本,采用非洲绿猴肾细胞（Vero Cell）和Vero-E6细胞进行VZV分离,从致细胞病变的培养上清液提取脱氧核糖核酸进行聚合酶链反应,并对扩增产物测序,分析其基因型别。结果2007年11月～2008年4月,上海市闵行区共发生29起水痘爆发疫情,罹患271例,平均罹患率0.42%;有水痘减毒活疫苗（Varicella Attenuated Live Vaccine,VarV）接种史患者37例,占病例总数的13.65%。以2007年11、12月病例数最多,有明显的地区聚集趋势,人口流动大的地区罹患率高。2例患者VZV分离阳性,均为J基因型。结论上海市闵行区冬春季水痘疫情严峻,VZV基因型别与VarV Oka株一致。应加强中、小学及托幼机构易感人群的VarV接种,预防控制水痘疫情。

Epidemiological Characteristic of Varicella and Varicella-Zoster Virus Genotype in Minhang District of Shanghai

Objective To describe the epidemiological characteristic of varicella,and to fi nd out the genotype of the prevalent Varicella-Zoster Virus （VZV） in Minhang,Shanghai. Analysis was carried out during Nov. 2007 to Apr 2008. Methods The data collected from the National Diseases Reporting Management System （NDRS） and Provincial Disease Surveillance Point System （DSP）. Samples from herpes of patients were also collected to isolate VZV in Vero and Vero-E6 cell lines,then to detected if cytopathic effect （CPE） by PCR,and fi nally to identifi y the genotype by sequence analysis. Results 29 outbreaks of 271 cases occurred in Minhang during Nov. 2007 to Apr. 2008,and attack rate was 0.42% in average. Among the cases,37 （13.65%） had vaccinated before getting varicella. Most cases occurred in November and December,and clustered in some areas with population migrant frequently. 2 VZV strains were isolated and identifi ed as genotype J. Conclusion The prevalence of varicella in Minhang was serious. .The varicella prevention and control among schools and kindergartens should be strengthened by propaganda and vaccination.