Lin X J, Liu G F, Wang M, Tao Z X, Wang S T, Song L Z, Zhang L, Xu A Q
Division of Expanded Immunization Program, Shandong Center for Disease Control and Prevention; Academy of Preventive Medicine, Shandong University; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Jinan 250014, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2019 Feb 6;53(2):174-178. doi: 10.3760/cma.j.issn.0253-9624.2019.02.010.
To characterize the etiology and epidemiological characteristics of the acute meningitis and encephalitis syndrome (AMES) in Jinan city in 2013-2016. The epidemiological data, clinical diagnosis, serum and cerebrospinal fluid (CSF) specimens were collected from 3 577 AMES cases in 6 sentinel hospitals in Jinan city in 2013-2016. Samples of all cases were made sero-diagnosis for Immunoglobulin (Ig) M antibody to Japanese encephalitis virus (JEV) and negative cases of JEV for enterovirus (EV), mumps virus (MuV) and herpes simplex virus (HSV) by enzyme-linked immunosorbent assay (ELISA). Virus isolation and molecular identification were performed. Positive rates were analyzed by Chi-square test. In 2013-2016, the positive rates of JEV, EV, MuV and HSV were 9.0% (322/3 577 cases), 22.1% (643/2 916 cases), 9.9% (289/2 916 cases), 26.9% (783/2 916), respectively. Of these, the positive rates of JEV were 32.9% (261/794), 1.2% (14/1 175), 1.0% (8/807) and 4.9% (39/801 cases); EV: 19.5% (91/466), 35.1% (342/974 cases), 15.5% (115/743) and 13.0% (95/733); MuV: 9.2% (43/466), 14.4% (140/974), 9.0% (67/743) and 5.3% (39/733). HSV: 35.4% (165/466), 38.5% (375/974), 25.7% (191/743) and 7.1% (52/733). There were significant differences in positive rates of 4 kinds of viruses in 2013-2016 (<0.001). A total of 81 EV strains belonging to 8 serotypes were isolated from 1 020 CSF specimens. The positive rates were 4.8% (6 cases), 13.1% (55 cases), 4.1% (7 cases) and 4.2% (13 cases) from 2013 to 2016. Coxsackievirus (CV) B5, echovirus (E) 6 and E30 accounted for 46% (37 isolates), 22% (18 isolates) and 21% (17 isolates) of all strains. The AMES cases in Jinan city in 2013-2016 were mainly caused by HSV, EV, MuV, JEV. CVB5, E6 and E30 were the dominant serotypes of EV associated with AMES cases in Jinan city.
旨在明确2013 - 2016年济南市急性脑膜炎和脑炎综合征（AMES）的病因及流行病学特征。收集了济南市6家哨点医院2013 - 2016年3577例AMES病例的流行病学资料、临床诊断结果、血清及脑脊液（CSF）标本。采用酶联免疫吸附试验（ELISA）对所有病例样本进行日本脑炎病毒（JEV）免疫球蛋白（Ig）M抗体血清学诊断，对JEV阴性病例检测肠道病毒（EV）、腮腺炎病毒（MuV）和单纯疱疹病毒（HSV）。进行病毒分离和分子鉴定。采用卡方检验分析阳性率。2013 - 2016年，JEV、EV、MuV和HSV的阳性率分别为9.0%（322/3577例）、22.1%（643/2916例）、9.9%（289/2916例）、26.9%（783/2916例）。其中，JEV的阳性率分别为32.9%（261/794）、1.2%（14/1175）、1.0%（8/807）和4.9%（39/801例）；EV为19.5%（91/466）、35.1%（342/974例）、15.5%（115/743）和13.0%（95/733）；MuV为9.2%（43/466）、14.4%（140/974）、9.0%（67/743）和5.3%（39/733）。HSV为35.4%（165/466）、38.5%（375/974）、25.7%（191/743）和7.1%（52/733）。2013 - 2016年4种病毒的阳性率存在显著差异（<0.001）。从1020份CSF标本中分离出81株属于8个血清型的EV毒株。2013 - 2016年的阳性率分别为4.8%（6例）、13.1%（55例）、4.1%（7例）和4.2%（13例）。柯萨奇病毒（CV）B5、埃可病毒（E）6和E30分别占所有毒株的46%（37株）、22%（18株）和21%（17株）。2013 - 2016年济南市的AMES病例主要由HSV、EV、MuV、JEV引起。CVB5、E6和E30是济南市与AMES病例相关的EV优势血清型。
