Miki Kenji, Komase Katsuhiro, Mgone Charles S, Kawanishi Ryuta, Iijima Masumi, Mgone Joyce M, Asuo Peter G, Alpers Michael P, Takasu Toshiaki, Mizutani Tomohiko
Department of Neurology, Nihon University School of Medicine, Tokyo, Japan.
J Med Virol. 2002 Sep;68(1):105-12. doi: 10.1002/jmv.10176.
A very high annual incidence of 56 per million population below the age of 20 years for subacute sclerosing panencephalitis (SSPE) has been reported from Papua New Guinea (PNG). In a more recent study, we have confirmed this unusual high incidence for Eastern Highlands Province (EHP) of PNG. In the study, it was observed that the vaccination rate among SSPE patients registered at Goroka Base General Hospital (GBGH) in EHP was higher than that of other infants in the province in recent years. To identify the measles virus (MV) responsible for SSPE in EHP, sequence analysis of hypervariable region of the N gene was performed from 13 MV genomes: 2 amplified from clinical specimens of SSPE patients and 11 from acute measles patients. In 2 cases among the 11 with acute measles, nucleotide sequence of the entire H gene derived from isolated viruses was determined. Both nucleotide sequence and phylogenetic tree analyses showed that the amplified MV cDNAs were closely related to one another and belonged to the D3 genotype though they were different from any previously reported MV sequences. No genome sequences of vaccine strains were detected. These findings suggest that the MV strains prevailing in the highlands of PNG belong to genotype D3 of the MV and this wild-type MV rather than the vaccine strains was likely to be responsible for SSPE in these patients.
据报道，巴布亚新几内亚（PNG）20岁以下人群中亚急性硬化性全脑炎（SSPE）的年发病率非常高，达每百万人56例。在最近的一项研究中，我们证实了PNG东部高地省（EHP）的这一异常高发病率。在该研究中，观察到近年来在EHP的戈罗卡基地综合医院（GBGH）登记的SSPE患者的疫苗接种率高于该省其他婴儿。为了鉴定EHP中导致SSPE的麻疹病毒（MV），对13个MV基因组的N基因高变区进行了序列分析：2个从SSPE患者的临床标本中扩增得到，11个从急性麻疹患者中扩增得到。在11例急性麻疹患者中的2例中，测定了分离病毒的整个H基因的核苷酸序列。核苷酸序列和系统发育树分析均表明，扩增的MV cDNA彼此密切相关，属于D3基因型，尽管它们与之前报道的任何MV序列均不同。未检测到疫苗株的基因组序列。这些发现表明，PNG高地流行的MV株属于MV的D3基因型，并且这种野生型MV而非疫苗株可能是这些患者发生SSPE的原因。
