肾综合征出血热发病率与气象因素关系的研究

目的 探索影响肾综合征出血热发病率的气象因素及其定量关系.方法 运用病例交叉设计思想,对某监测点历年逐月的HFRS疫情资料和气象资料,建立气象因素对HFRS发病率影响的分季节多变量logistic回归模型.结果 影响HFRS流行的主要气象因素,春季为前6个月最低气温、前12个月平均气温、前6个月降雨量、前12个月降雨量、当月平均相对湿度、前3个月平均相对湿度、前3个月平均气压、前6个月平均气压、当月平均风速;夏季为当月平均气温、当月降雨量、前3个月平均相对湿度、前12个月平均相对湿度、前3个月总日照时间、前3个月平均风速;秋季为前6个月平均气温、当月平均相对湿度、当月总日照时间、前3个月平均风速;冬季为前3个月降雨量、前6个月降雨量、前12个月降雨量、当月平均相对湿度、前3个月平均相对湿度、前3个月日照时数、前3个月平均风速.结论 平均气温、降雨量、相对湿度、日照时数、平均气压、风速等气象因素均不同程度地影响HFRS,不同季节各气象变量的作用不同.     

肾综合征出血热控制效果观察

目的：控制肾综合征出血热（HFRS）高发疫区人群发病率。方法：实施以疫苗接种为主,灭鼠和健康教育为辅的综合性防制措施。结果：在从事野外劳动的16－60岁青壮年农民中,免疫覆盖率达51.86%,免疫阳转率为97.6％,从而使周村乡5个村的发病率由1997年的490.23/10 下降到1999年的零。结论：以疫苗接种为主的综合性防制措施,对HFRS高发疫区的控制效果理想。     

新流行期汉城型汉坦病毒全S及部分L与M基因核苷酸序列测定及研究

目的：为获得SED型病毒基因组更为详尽的资料,也为局部爆发的原因提供科学的资料。方法：病毒分离、McAbs分型RT－PCR扩增及核苷酸序列测定。结果:首次测出我国SEO型病毒较为完整的S片段及部分L片段和M片段并与76－118、Seoul、SR11（在全S片段）;76－118、C4、L99、Seoul（在L片段）;10A、A9、C1－1、JB3、L99、SD227、SD70、SED（M片段）株核苷酸同源性进行比较,分别为64．2％、91．89％、96．8％及70．8％、72．0％、95．3％、95．9％及97．3％、63．0％、66．0％、93．0％、94．3％、96．3％、97．3％、94．7出的氨基酸同源性分别为：80．5％、95．4％、97．36％、及75．6％、75．1％、97．7％、97．36％及96．0％、78．8％、79．8％、94．9％、98．0％、97．0％、98．0、97．0％。结论：①不存在病毒基因组间的重排,即基因重排不是造成此次HFRS流行的原因。②SEO型病毒表现出明显的地理聚集现象。③选用与本地区流行的汉坦病毒型别相同的疫苗是行之有效的防止措施。     

我国SEO型汉坦病毒L基因核苷酸序列测定研究

目的：为各基因型或亚型病毒生物学表型研究打基础,对疫苗的选择使用提供科学依据。方法：将获得SEO型病毒分离、MCABS分型RT－PCR扩增及核苷酸序列测定。结果：首次测出我国SEO型病毒部分L基因核苷酸序列,并与76－118、C4、L99、Seoul株的核苷酸及氨基酸同源性进行比较,分别为70．8％、72％、95．3％、95．9％及75．6％、751％、97．7％、97．3％。结论：病毒基因组间的重排不是造成发病高峰的原因。     

血必净注射液治疗肾综合征出血热合并急性肾功能衰竭42例临床疗效观察

目的:观察血必净注射液治疗肾综合征出血热(HFRS)合并急性肾功能衰竭(ARF)的临床疗效。方法:将72例ARF患者随机分为治疗组(Ⅰ组,42例)和对照组(Ⅱ组,30例),Ⅰ组在西医综合治疗的基础上加用血必净注射液,Ⅱ组仅采用西医综合治疗。结果:Ⅰ组总有效率为95.24%,Ⅱ组为80.00%,2组比较具有显著性差异(P<0.05);Ⅰ组肾功能恢复正常时间显著短于Ⅱ组(P<0.05)。结论:血必净注射液治疗HFRS合并ARF具有良好疗效。     

湖南省2006年肾综合征出血热监测研究

目的掌握湖南省HFRS疫源地范围、类型、人群分布和流行规律以及宿主动物种类、带病毒率等情况,为防制HFRS提供科学依据。方法按照2006年《湖南HFRS监测实施方案》,在全省7个监测点系统开展HFRS的流行病学和病原学监测。采用直接免疫荧光法（DFA）检测宿主动物肺组织汉坦病毒（HV）抗原,了解自然感染汉坦病毒情况,并从HV阳性鼠肺标本中提取病毒RNA,应用HV型特异性引物进行RT-PCR扩增及核苷酸序列测定,并进行基因分型。结果2006年共报告病例560例,发病率0.89/10万。共捕获654只宿主动物,总鼠密度为3.15%,鼠带毒率为1.31%,在浏阳市、邵东县室内捕获的7只褐家鼠、黑线姬鼠、小家鼠、黄胸鼠肺标本中均发现携带汉城型（SEO）病毒,双峰县室外捕获的1只黑线姬鼠肺标本则携带汉坦型（HTN）病毒。结论湖南省为SEO型和HTN型混合型疫区,以SEO型为主。防制HFRS应以灭鼠、免疫高危人群、开展健康教育等的综合防制措施。     

Puumala hantavirus genetic variability in an endemic region (Northern Sweden)

Puumala hantavirus (PUUV), naturally harboured and shed by bank voles (Myodes [Clethrionomys] glareolus), is the etiological agent to nephropathia epidemica (NE), a mild haemorrhagic fever with renal syndrome. Both host and virus are found throughout much of the European continent and in northern Sweden NE is the second most prevalent serious febrile viral infection after influenza. The reliability of diagnostics by PCR depends on genetic variability for the detection of viral nucleic acids in unknown samples. In the present study we evaluated the genetic variability of PUUV isolated from bank voles in an area of northern Sweden highly endemic for NE. Genetic variability among bank voles was also investigated to evaluate co-evolutionary patterns. We found that the viral sequence appeared stable across the 80km study region, with the exception of the southernmost sampling site, which differed from its nearest neighbour by 7%, despite a geographical separation of only 10km. The southernmost sampling site demonstrated a higher degree of genetic similarity to PUUV previously isolated 100km south thereof; two locations appear to constitute a separate PUUV phylogenetic branch. In contrast to the viral genome, no phylogenetic variance was observed in the bank vole mtDNA in this study. Previous studies have shown that as a result of terrestrial mammals' postglacial re-colonization routes, bank voles and associated PUUV of a southern and a northern lineage established a dichotomous contact zone across the Scandinavian peninsula approximately 100-150km south of the present study sites. Our observations reveal evolutionary divergence of PUUV that has led to dissimilarities within the restricted geographical scale of the northern host re-colonization route as well. These results suggest either a static situation in which PUUV strains are regionally well adapted, or an ongoing process in which strains of PUUV circulate on a geographical scale not yet reliably described.     

长春龙嘉国际机场口岸鼠间肾综合征出血热监测

目的掌握长春龙嘉国际机场口岸鼠类肾综合征出血热（HFRS）的流行性、特征,分析口岸鼠类传播HFRS的危险性为采取相应的防治措施提供依据。方法从2006．4～2007．3,采用常规夹日法捕捉鼠类。用直接免疫荧光法（FA）进行鼠类肾综合征出血热抗原检测,对监测数据进行统计分析。结果长春龙嘉国际机场口岸平均鼠密度为1．81％;小家鼠为室外主要优势鼠种（构成比50．77％）,褐家鼠为室内主要优势鼠种（构成比4．10％）。小家鼠带毒率5．05％,黑线姬鼠带毒率6．33％,鼠类肾综合征出血热平均带毒率为5．13％。8月份为鼠类活动高峰期。结论为了防止鼠间肾综合征出血热的传播,保护口岸人群健康,口岸出入境检验检疫部门应及时进行媒介控制。     

Serum antibodies to structural proteins of Hantavirus arise at different times after infection.

An enzyme-linked immunosorbent assay (ELISA) was developed for the quantification of serum antibodies against group-specific epitopes of the glycoproteins (G1, G2) and nucleoprotein (NP) of the genus Hantavirus. This assay was used to study the kinetics of the development of serum antibodies after natural infection with Puumala-like virus in humans. To this end a panel of 34 serum samples collected from individuals at different times after natural infection was tested by the ELISA. The samples were also tested for specific IgM and IgG levels against Puumala-like virus, which provided confirmatory data about the presumed timing of infection. It was shown that serum antibodies against the G1 epitope were present in the acute and early convalescent period just before antibodies to the NP epitope could be demonstrated. In contrast, antibodies to two G2 epitopes were present not earlier than in the convalescent and late convalescent period. Since all these categories of antibodies seem to persist for long periods, antibodies against the G1 epitope and the NP epitope may be of specific diagnostic value. Furthermore, levels of G1-specific antibodies and antibodies to either NP or G2 may allow estimation of the time elapsed following initial infection.