Limberková R, Lexová P
Epidemiol Mikrobiol Imunol. 2014 Feb;63(1):36-42.
To extend the present routine serological diagnosis of mumps with the methods of direct detection of the pathogen and subsequent genotyping of the isolated viruses in an attempt to obtain more detailed data on recent mumps viruses circulating in the Czech Republic. Sub-goals were to point out the particularities of the laboratory examination in the population with a high vaccine coverage and to evaluate the current epidemiological situation.
Altogether 47 buccal swabs from patients with suspected mumps were included in the study. Clinical specimens collected at the onset of clinical symptoms were obtained from five administrative regions of the Czech Republic from February 2012 to December 2012. Vero cell cultures were used for virus isolation and isolates were identified using real-time quantitative polymerase chain reaction (RT-qPCR). Genotyping was performed by the WHO Regional Reference Laboratory for Measles, Mumps, and Rubella (RRL MMR), Robert Koch Institute, Berlin. The EPIDAT system was used as a source of epidemiological data.
From 47 buccal swabs, 20 mumps viruses were isolated on Vero cells and in seven other specimens, the presence of viral RNA without positive isolation was only detected by RT-qPCR. Nineteen isolates were referred for genotyping. The phylogenetic analysis of the SH gene classified them into genotype G, as four variants. In both 2011 and 2012, most cases occurred in vaccinated patients (80%), with 15-19-year-olds being the most affected age group. The leading complication was orchitis, followed by meningitis. More complications were reported in non-vaccinated individuals.
The increased incidence of mumps cases in the Czech Republic in 2012 was due primarily to genotype G, the leading cause of mumps in most European countries since 2005. The presence of genotype G was first reported in the Czech Republic in 2006. In the context of the unfavourable epidemiological trend, molecular epidemiological studies including genotyping of recent mumps virus strains appear to be necessary. A detailed monitoring could be helpful in elucidating the pattern of virus circulation and in designing strategies to control emerging outbreaks. The vaccination efficacy in relation to the causative genotype and possible role of waning immunity in mumps outbreaks are the issues that need to be addressed.
采用直接检测病原体及对分离出的病毒进行基因分型的方法,扩展目前流行性腮腺炎的常规血清学诊断,以便获取关于捷克共和国近期流行的腮腺炎病毒的更详细数据。次要目标是指出疫苗接种覆盖率高的人群中实验室检查的特殊性,并评估当前的流行病学形势。
本研究共纳入47例疑似腮腺炎患者的颊拭子样本。临床症状出现时采集的临床标本于2012年2月至12月取自捷克共和国的五个行政区。使用Vero细胞培养进行病毒分离,并用实时定量聚合酶链反应(RT-qPCR)鉴定分离株。基因分型由位于柏林的世界卫生组织麻疹、腮腺炎和风疹区域参考实验室(RRL MMR)、罗伯特·科赫研究所进行。使用EPIDAT系统作为流行病学数据来源。
从47份颊拭子样本中,在Vero细胞上分离出20株腮腺炎病毒,另外7份样本中,仅通过RT-qPCR检测到病毒RNA存在但未成功分离。19株分离株被送去进行基因分型。对SH基因的系统发育分析将它们归类为G基因型,有四个变体。在2011年和2012年,大多数病例发生在接种疫苗的患者中(80%),15至19岁年龄组受影响最大。主要并发症是睾丸炎,其次是脑膜炎。未接种疫苗的个体报告的并发症更多。
2012年捷克共和国腮腺炎病例发病率增加主要归因于G基因型,自2005年以来该基因型是大多数欧洲国家腮腺炎的主要病因。G基因型于2006年首次在捷克共和国被报告。在不利的流行病学趋势背景下,包括对近期腮腺炎病毒株进行基因分型在内的分子流行病学研究似乎很有必要。详细监测有助于阐明病毒传播模式并设计控制新出现疫情的策略。与致病基因型相关的疫苗接种效果以及腮腺炎疫情中免疫减弱可能发挥的作用是需要解决的问题。