中国淮阳山地区由新蜱传布尼亚病毒引起的出血热
중국회양산지구유신비전포니아병독인기적출혈열
Hemorrhagic fever caused by a novel tick-borne Bunyavirus in Huaiyangshan,China
  • 万方数据
    中华流行病学杂志 중화류행병학잡지
    CHINESE JOURNAL OF EPIDEMIOLOGY
    2011年 3期 209-220 ,共12页

    张永振%周敦金%熊衍文%陈小萍%贺永文%孙强正%余滨%李娟%代永安%田俊华%覃新程%金东%崔志刚%罗雪莲%李伟%卢珊%王文%彭劲松%郭文平%李明慧%李振军%张少敏%陈晨%王艳%Menno D.de Jong%徐建国

    장영진%주돈금%웅연문%진소평%하영문%손강정%여빈%리연%대영안%전준화%담신정%금동%최지강%라설련%리위%로산%왕문%팽경송%곽문평%리명혜%리진군%장소민%진신%왕염%Menno D.de Jong%서건국



    研究背景 2009-2010年4月至7月,我国淮阳山地区农民中出现不明原因的严重出血热样病例.方法 采集疑似病例的临床标本(血液、尿液、粪便和咽拭子),在患者所在地采集蚊和蜱.从2例患者的血液样本中分离到2株病毒,并进行全基因组测序分析.采用病毒特异的RT-PCR对其他病例及节肢动物进行病毒检测,对RT-PCR阳性病例的临床和流行病学资料进行分析.结果 从2例患者的血液及从犬身上采集到的长角血蜱中分离到1种未知病毒.全基因组测序分析发现该病毒为布尼亚病毒科的一个新成员,与白蛉病毒属最接近,是其中的一个新分支.58例疑似病例中33例RT-PCR结果阳性.病例临床特征主要表现为发热、乏力、恶心、呕吐和腹泻.主要实验室结果包括白细胞及血小板减少,凝血时间异常和肝酶升高.3例患者出现出血症状,5例死亡(死亡率15%).结论 我国淮阳山地区存在着一种严重威胁生命健康的新蜱传布尼亚病毒.对于该病毒的流行病学、地理分布,以及脊椎动物宿主的生态学等需要作进一步的研究.
    연구배경 2009-2010년4월지7월,아국회양산지구농민중출현불명원인적엄중출혈열양병례.방법 채집의사병례적림상표본(혈액、뇨액、분편화인식자),재환자소재지채집문화비.종2례환자적혈액양본중분리도2주병독,병진행전기인조측서분석.채용병독특이적RT-PCR대기타병례급절지동물진행병독검측,대RT-PCR양성병례적림상화류행병학자료진행분석.결과 종2례환자적혈액급종견신상채집도적장각혈비중분리도1충미지병독.전기인조측서분석발현해병독위포니아병독과적일개신성원,여백령병독속최접근,시기중적일개신분지.58례의사병례중33례RT-PCR결과양성.병례림상특정주요표현위발열、핍력、악심、구토화복사.주요실험실결과포괄백세포급혈소판감소,응혈시간이상화간매승고.3례환자출현출혈증상,5례사망(사망솔15%).결론 아국회양산지구존재착일충엄중위협생명건강적신비전포니아병독.대우해병독적류행병학、지리분포,이급척추동물숙주적생태학등수요작진일보적연구.
    Background:From April to July in 2009 and 2010,unexplained severe hemorrhagic fever-like illnesses occurred in farmers from the Huaiyangshan mountains range.Methods:Clinical specimens (blood,urine,feces,and throat swabs) from suspected patients were obtained and stored.Mosquitoes and ticks in affected regions were collected.Virus was isolated from 2 patients and characterized by whole genome sequencing.Virus detection in additional patients and arthropods was done by virus-specific reverse transcription (RT) PCR.Clinical and epidemiological data of RT-PCR confirmed patients were analyzed.Results:An unknown virus was isolated from blood of two patients and from Haemaphysalis ticks collected from dogs.Whole genome sequence analysis identified the virus as a novel member of the family Bunyaviridae,most closely related to the viruses of the genus Phlebovirus within which it forms a separate lineage.Subsequently,infection was confirmed by RT-PCR in 33 of 58 suspected patients.The illness in these patients was characterized by fever,severe malaise,nausea,vomiting,and diarrhea.Prominent laboratory findings included low white cell- and platelet counts,coagulation disturbances,and elevation of liver enzymes.Hemorrhagic complications were observed in 3 cases,5 (15%) patients died.Conclusions:A novel tick-borne Bunyavirus causing life-threatening hemorrhagic fever in humans has emerged in the Huaiyangshan mountain areas of China.Further studies are needed to determine the epidemiology,geographic distribution and vertebrate animal ecology of this virus.
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