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P4]、P8]和P6]型为常见。最常见的P-G组合型是P4]G2,占34.1％(14/41),其次是P8]G1和P6]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。

Rotavirus surveillance data from Kunming Children's Hospital, 1998-2001

Objective To study the epidemiological status on rotavirus diarrhea in Kunming to improve the rotavirus vaccine immunization program. Methods A hospital-based sentinel surveillance program for rotavirus was set up among children less than 5 years old with acute diarrhea in Kunming Children's Hospital. Clinical information and fecal specimens were collected and rotavirus were detected by polyacrylamide gel electrophoresis(PAGE) and/or enzyme linked immunosorbent assay (ELISA). Positive specimens were further serotyped or genotyped by ELISA and/or RT-PCR. Results During the three years of surveillance, 466 specimens were collected. Rotavirus were detected on 246 (52. 8%) specimens. 97% of the rotavirus diarrhea cases occurred among children less than 2 years old. There was a peak of admissions for rotavirus diarrhea cases between October and December which accounted for 48% of all the rotavirus hospitalizations each year. Among 204 specimens with G serotyping, the predominant strain was serotype G1(47.5%) followed by G2 (17. 6%), G3 (15.7%), G9 (4.9%) and G4(1.0%). Mixed infection (2. 5%) were rare and 22 specimens (10.8%) remained non-typeable. P genotyping showed P 4],P8] and P6] were the most common strains, accounting for 29. 3%, 27. 6% and 13.8% respectively. P4]G2 was the most common strain which accounted for 34. 1% (14/41) followed by P 8] G1(29.3%) and P6]G9 (12.2%). Another 7 uncommon P-G combinations were also identified. Conclusion Rotavirus was the major cause of acute diarrhea in Kunming. An effective rotavirus vaccine for prevention and control of rotavirus diarrhea should be developed.