中国2013年麻疹/风疹实验室网络的运转与监测

目的评价中国（未包括香港、澳门特别行政区和台湾地区,下同）2013年麻疹/风疹实验室网络（Measles/Rubella Laboratory Network,M/RLN）的运转状况。方法分析中国2013年麻疹监测报告管理信息系统中实验室数据和全国M/RLN监测数据,评价中国2013年M/RLN运转的各项指标。结果 1血清学检测：中国2013年共采集散发麻疹疑似病例（Measles-like Illnesses,MLIs）74 296例的血清标本,占中国散发MLIs的97.30%;实验室确诊的散发麻疹病例26 686例,占散发MLIs的34.02%;中国2013年报告MLIs爆发157起,实验室证实麻疹爆发108起,风疹爆发26起。2病毒学监测：中国2013年M/RLN从29个省（自治区、直辖市,下同）分离到2325株麻疹病毒,其中2217株为H1a基因亚型,13株为A基因型,47株为D9基因型,45株为D8基因型,3株为B3基因型。2013年从17个省分离到187株风疹病毒,其中103株为1E基因型,84株为2B基因型。3质量控制：作为世界卫生组织（World Health Organization,WHO）西太平洋区麻疹参比实验室,中国疾病预防控制中心（Center for Disease Control and Prevention,CDC）病毒病预防控制所国家麻疹/风疹实验室通过了2013年WHO的职能考核和现场认证。8个省级CDC麻疹/风疹实验室（Measles/Rubella Laboratory,M/RL）（包括新疆、北京、河北、四川、黑龙江、宁夏、广东和广西）通过了2013年WHO专家组的现场认证;32个省级（包括新疆生产建设兵团）CDC M/RL,全部通过了由M/RLN组织的血清标本复核和WHO组织的职能考核。结论中国2013年M/RLN运转良好,MLIs的实验室诊断比例和病原学检测比例进一步提高,为麻疹和风疹的鉴别诊断和病原学监测提供了良好的技术平台,同时也积累了大量的本土麻疹/风疹病毒流行株和输入株的基因背景资料,为在中国实现消除麻疹的目标提供了重要的和实验室技术支撑。

Surveillance and Running status of Laboratory Network for Measles and Rubella in 2013,China

Objective Evaluate the 2013 running performance of the measles/rubella laboratory network（ M/RLN） in China（ excluding Hong Kong Special Administrative Region,Macao Special Administrative Region and,Taiwan Region）.Methods We analyzed epidemiology surveillance and laboratory surveillance data from M /RLN from 2013,and examined performance quality indicators.Results 1.Serologic surveillance.A total of 74,296 sporadic MILs serum samples were collected in 2013,with a collection efficiency of 97.30%; 26,686 sporadic MILs were laboratory-confirmed with measles immunoglobulin（ Ig） M testing positive,with a positive percentage of 34.02%.A total of 157 suspected measles outbreaks were reported in 2013,108 and 26 were confirmed as measles and rubella outbreaks respectively.2.Virologic surveillance.A total of 2,325 measles virus specimens were isolated by 29 provincial measles /rubella laboratories in 2013.Of these,2,217 specimens were identified as genotype H1 a,47 were genotype D9,45 were genotype D8,3 were genotype B3,and 13 were genotype A.A total of 179 rubella virus specimens were isolated by 16 provincial laboratories in 2013.Of these,97 and 82 isolates were identified as genotype 1E and 2B respectively.3.Quality control.The national laboratory for measles /rubella passed the proficiency test and on-site review by the World Health Organization（ WHO）with good performance in 2013.All 32 provincial measles /rubella laboratories（ included the Xinjiang Production and Construction Corps） passed the serum sample confirmation test held by the national laboratory for measles /rubella,and the proficiency test held by WHO.Xinjiang,Beijing,Hebei,Sichuan,Heilongjiang,Ningxia,Guangdong,and Guangxi provincial measles /rubella laboratories passed their on-site review.Conclusion In 2013,the M /RLN performed well.The ratio of laboratory diagnosis and pathogen detection increased from previous years,so that a higher quality technical platform provided measles and mumps differential diagnoses and etiological surveilla