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目的:对2007年6月上旬深圳市龙岗区某工厂流感暴发流行的病原学进行分离并鉴定和分子流行病学研究。方法:采集发热患者的鼻咽拭子和急性期患者血清,采用荧光定量RT-PCR方法进行核酸检测,用MDCK细胞对病人的咽拭标本进行分离培养,并对分离到的流感病毒HA l基因核苷酸序列进行测定及抗原分析,同时检测了患者的血清抗体水平。结果:27份鼻咽拭子标本中荧光定量RT-PCR检测阳性17份,阳性率为63.0%(17/27);MDCK细胞分离培养,其中2份鼻咽拭子标本中分离出2株H3N2亚型流感病毒,阳性率7.4%(2/27);6例病人的双份血清学检测结果显示:恢复期抗体比较急性期抗体有4倍或以上增长。另将其中1株的HA l基因测序,与国家代表株及2006、2007年WHO推荐的疫苗株进行比较,发现在HA蛋白的A、B或C抗原决定簇上出现氨基酸发生变异,表明分离到的流感病毒发生HA蛋白抗原漂移。结论:这起发生抗原漂移H3N2亚型流感病毒造成这次流感暴发的流行。
OBJECTIVE: To isolate and identify the epidemiology of influenza outbreak in a factory in Longgang District of Shenzhen City in early June 2007 and to study its molecular epidemiology. Methods: Nasopharyngeal swabs and acute phase sera from patients with fever were collected. The nucleic acids were detected by real-time fluorescent quantitative RT-PCR. MDCK cells were used to isolate and culture the pharyngeal swab samples. The HA1 gene of influenza virus Nucleotide sequence determination and antigen analysis, while testing the patient’s serum antibody levels. Results: Seventeen nasopharyngeal swab specimens were positive by fluorescence quantitative RT-PCR and the positive rate was 63.0% (17/27). MDCK cells were isolated and cultured. Two strains of H3N2 The positive rate of subtype influenza virus was 7.4% (2/27). The results of double serological tests in 6 patients showed that the antibody in recovery phase had a 4-fold or more increase in antibody compared with that in acute phase. In addition, one HA1 gene was sequenced and compared with the national representative strains and the WHO vaccine strains recommended by the WHO in 2006 and 2007. Amino acid variation appeared on the A, B or C antigenic determinants of the HA protein, indicating that the isolated Of the influenza virus HA protein antigen drift occurred. Conclusion: This outbreak of H3N2 subtype influenza virus antigen drift caused the outbreak of the flu.