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探讨2016年12月深圳市光明新区某小学一起急性呼吸道病毒感染暴发疫情的流行病学及病原学特点。采用相应的流行病学个案调查表对疫情进行现场调查,采集患者咽拭子标本,使用实时荧光定量PCR方法对标本进行流感样病例筛查,筛查后的阴性标本进行呼吸道病毒核酸检测,用腺病毒六邻体蛋白基因作为靶基因对腺病毒初筛阳性标本进行扩增并测序,测序结果在GenBank上进行序列比较后使用BLAST和MEGA 5.0软件进行分析。该起疫情首例病例发病时间为2016年12月2日,末例病例发病时间为2016年12月17日,共发病34例,期间出现3次发病高峰,患者均为学生,其中男女生各17例,男女比例1∶1。患者体温均<39℃,大部分有头晕、头痛症状,少数伴有咽痛、咳嗽症状。发病的四个班级间的罹患率差异有统计学意义。共采集8份咽拭子标本,经实时荧光定量PCR检测均为腺病毒阳性,其中1份合并鼻病毒阳性。8份标本用分型引物检测并分析序列确定均为腺病毒E亚属4型。此次急性呼吸道感染暴发疫情为连锁式传播,由腺病毒4型引起,毒株序列与深圳、国内其他城市分离的腺病毒4型毒株序列具有高度同源性,提示该毒株可用于疫苗株筛选。早期发现可疑病例并采取隔离措施是预防腺病毒感染暴发的最佳手段。
To investigate the epidemiological and etiological characteristics of an outbreak of acute respiratory virus infection in a primary school in Guangming New District of Shenzhen City in December 2016. The corresponding epidemiological case questionnaire was used to carry out on-the-spot investigation of the epidemic situation, throat swab specimens were collected, real-time fluorescence quantitative PCR method was used to screen samples of influenza-like cases, and negative samples after screening were used to detect respiratory virus nucleic acid The adenovirus hexon protein gene was used as the target gene to amplify and sequenced adenovirus positive samples. The sequencing results were compared in GenBank and analyzed by BLAST and MEGA 5.0 software. The onset of the first case of the outbreak was December 2, 2016, the last case onset time was December 17, 2016, a total of 34 cases of disease, during which three peak incidence, the patients were students, male and female students 17 cases, male to female ratio of 1: 1. Patients with body temperature <39 ℃, most have dizziness, headache symptoms, a few with sore throat, cough symptoms. The incidence of attack among the four classes was statistically significant. A total of 8 throat swabs were collected. All of them were positive for adenovirus by real-time fluorescence quantitative PCR, and 1 of them were positive for rhinovirus. 8 samples were detected by typing primers and analysis of sequences identified as adenovirus E subtype 4. The outbreak of this acute respiratory infection is a chain transmission, caused by the adenovirus type 4, the strain sequence and other cities in Shenzhen and other strains of adenovirus type 4 has a high degree of homology, suggesting that the strain can be used for the vaccine Strains screening. Early detection of suspected cases and isolation measures is the best way to prevent outbreaks of adenovirus infection.