辽宁省2012 — 2013年发热伴出血症候群监测分析

  目的  了解广东省发热伴出血症候群临床病例相关病原体感染情况，为临床诊断治疗和预防控制提供科学依据。  方法  选择广东省3个地市的6家医院作为哨点医院，共采集样本282份。分别使用捕获酶联免疫吸附试验（ELISA）法、间接ELISA法和双抗体夹心ELISA法检测登革病毒（DENV））、汉坦病毒（HTNV）、人钩端螺旋体（LS）和新布尼亚病毒（NBYV）IgM/IgG抗体；分别使用胶体金免疫层析法和巢式PCR方法检测恙虫病东方体（Ot）IgM/IgG抗体和核酸；采用蚀斑减少中和实验和显微镜凝集试验分别对DENV和LS的抗体阳性结果进一步确认。  结果  DENV、HTNV、Ot、LS和NBYV抗体的阳性率分别为4.61 %（13/282）、3.55 %（10/282）、24.82 %（70/282）、32.66 %（65/199）和0.39 %（1/254），其中NBYV抗体仅1例IgG阳性。DENV抗体中和实验确认6份标本阳性，LS显微凝集实验确认6份标本抗体阳性。恙虫病东方体核酸共有11份阳性，测序分型共有4个基因型。  结论  登革病毒、汉坦病毒、恙虫病东方体和人钩端螺旋体在广东省人群中均存在一定程度的感染率，但尚未发现存在新布尼亚病毒感染的实验室确认证据。

Fever with thrombocytopenia associated with a novel bunyavirus in China

  Objective  To examine the distribution of pathogens among patients suffering from syndromes of fever and haemorrhage in Guangdong province and to provide evidences for clinic diagnosis and treatment of the syndromes.  Methods  Totally 282 blood samples were collected from 282 patients with acute clinical symptoms of fever and haemorrhage at 6 sentinel hospitals in 3 prefectures of Guangdong province. Capture enzyme-linked immunosobent assay (ELISA), indirect ELISA and double-antibody sandwich ELISA were used for detections of imunoglobulin M/imunoglobulin G (IgM/IgG) antibody of dengue virus (DENV), Hantaan virus (HTNV), Leptospira (LS), and new bunyavirus (NBYV). Orientia tsutsugamushi (Ot) IgM/IgG antibody and nucleotide were tested with colloidal gold and nested-PCR. In addition, plaque reduction neutralization test and microscopic agglutination test were adopted to further confirm ELISA positive results of DENV and LS antibody.  Results  The antibody positive rates of specimens were 4.61% (13/282) for DENV, 3.55% (10/282) for HTNV, 24.82% (70/282) for Ot, 32.66% (65/199) for LS, and 0.39% (1/254) for NBYV, respectively. Only one sample was positive for IgG of NBYV. Totally 6 DENV positive samples were confirmed with plaque reduction neutralization test and 6 LS positive samples were confirmed with microscopic agglutination test. PCR detection identified 11 Ot nucleotide positive samples, with 4 genotypes based on sequencing.  Conclusion  Infection of dengue virus, Hantaan virus, Orientia tsutsugamushi, and Leptospira were not unusual, but the infection of new bunyavirus was rare among patients with syndromes of fever and haemorrhage in Guangdong province.