2015—2017年河源市感染性腹泻症状和病原学监测分析

目的 了解河源市感染腹泻流行状况和病原学分布特征,为疾病预防控制提供依据。方法 2015—2017年在河源市哨点监测医院开展腹泻症状和腹泻病毒监测,对符合病毒性感染腹泻病例定义的患者进行粪便标本的采集,应用ELISA方法检测轮状病毒,采用实时荧光RT-PCR方法检测诺如病毒、星状病毒、腺病毒,应用SPSS20.0软件进行统计学分析。结果 2015年5月—2017年4月河源市腹泻监测共采集673份标本,腹泻病毒总阳性率23.48%,分别检出诺如病毒(6.69%)、轮状病毒(16.79%),未检出星状病毒、腺病毒,诺如病毒均为GII型。71.11%的诺如病毒及80.53%的轮状病毒阳性标本来自5岁以下婴幼儿腹泻病例;60岁以上老年人腹泻病例总检出率为10.71%。轮状病毒在每年2月出现流行峰,诺如病毒在每年9—11月及2—3月出现检出率高峰。腹泻病例门诊就诊比例在0.36%与1.04%之间,与病原学检出率的秩相关分析呈显著正相关( 相关系数r＝0.493,P=0.014)。结论 诺如和轮状病毒是2015—2017年冬春季河源市感染腹泻的主要病原体,5岁以下婴幼儿是重点防控对象,结合腹泻症状监测可为疾病风险评估、预警提供可靠依据。

Infectious diarrhea symptoms and etiological surveillance in Heyuan City from 2015 to 2017

Objective To understand the infectious diarrhea epidemic status, symptoms and etiological distribution characteristics in Heyuan City from 2015 to 2017, so as to provide the evidence for improving the prevention and control of the disease. Methods From 2015 to 2017, the diarrhea symptoms were investigated and etiological surveillance was carried out in the sentinel surveillance hospitals in Heyuan City. ELISA and RT-PCR methods were used to detect Rotavirus and Norovirus in feces samples. Results From May 2014 to April 2017, 637 feces samples were collected, and the overall positive rate of diarrhea virus was 23.48%, including Norovirus GⅡ type (6.69%) and Rotavirus (16.79). Totally 71.11% of Norovirus positive samples and 80.53% of Rotavirus positive samples were collected from the diarrhea infants under 5 years old. The overall virus detection rate was 10.71% among the old diarrhea patients aged above 60 years. The peak prevalence of Rotavirus infection was shown in February, and peak prevalence of Norovirus infection was shown from February to March and from September to November respectively. The proportion of seeing a doctor of the diarrhea outpatients was between 0.36% and 1.04%, and the proportion was positive correlated with the etiological detection rate (r=0.493, P=0.014). Conclusion Norovirus and Rotavirus are the main pathogens of infectious diarrhea in Heyuan City in spring and winter from 2015 to 2017. The infants under 5 years old are the key population of prevention and control of infectious diarrhea.