摘要
目的了解云南省保山市发生2例狂犬病患者的流行病学特点，根据病原分子生物学特征分析可能的传染来源。方法采用狂犬病个案调查表进行流行病学调查，采集狂犬病死者脑组织标本，用直接免疫荧光试验（DFA）检测狂犬病病毒抗原，用RT—PCR法检测狂犬病病毒核酸，测定狂犬病病毒P、M和N基因全序列并根据其同源性比较及系统进化树进行分子流行病学分析。结果2006年7月保山市隆阳区发生1例人间狂犬病，2007年4月腾冲县发生1例狂犬病。2例患者犬伤暴露程度均为Ⅲ度。2例死亡病例均采集到脑组织（编号为CYN0601H和CYN0701H），经DFA和RT—PCR两种实验室方法检测确诊为狂犬病病毒阳性。CYN0601H和CYN0701H与国内外狂犬病病毒的P、M和N基因核苷酸和推导氨基酸序列同源性分析显示，CYN0601H和CYN0701H与泰国分离株的同源性最高。系统进化分析显示，2株病毒标本亲缘关系很近，同属于狂犬病病毒基因1型，且与泰国病毒株有较近的亲缘关系。结论从病原学和病毒分子水平证实云南省保山市2例患者均为狂犬病，保山市狂犬病病毒流行株可能为境外传人，应加强云南省边境地区狂犬病防制工作。
Objective To understand the epidemiological features of two rabies cases in Baoshan city year 2006 and 2007 and to analyze its source of infection. Methods Questionnaires were used to do the epidemiological survey on each of the rabies cases. Brain tissue samples of rabies patients were collect to detect the rabies virus by direct immunofiuorescence assay （DFA） and RT-PCR assay. Homology and phylogenetic tree were analyzed, based on the whole nucleotide and deduced amino acid sequence of P, M and N gene of rabies virus followed by molecular epidemiological analysis. Results In July 2006, one human rabies case was identified in Longyang district, and another one in Tengchong county in Baoshan city in 2007. The degrees of exposure of these two patients was all at degree Ⅲ. Two brain tissue samples among the dead patients （No; CYN0601H and CYN0701H） were confirmed positive by both DFA and RTPCR assay. The homology analysis of P, M and N gene sequences among CYN0601H, CYN0701H and other rabies strains isolated from other provinces and other counties, showed that the samples in Baoshan city shared the highest homology with the strains in Thailand. Phylogenetic analysis indicated that the two samples were very close and all belonged to genetype 1 Lyssavirus, with the closest relationship between samples in Baoshan city and strains in Thailand. Conclusion It was confirmed on the virus molecular level that the two patients in Baoshan city were both suffered from rabies. The prevalent strains in Baoshan city was probably imported from foreign country, suggesting that prevention and control measures on rabies virus in the boarder areas of Yunnan should be strengthened.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2008年第9期899-904,共6页
Chinese Journal of Epidemiology
基金
国家高技术研究发展计划“863”资助项目（SQ2006AA022112882）
