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目的分析腺病毒3型引起的咽结合膜热暴发流行病学特征和流行因素。方法通过描述性流行病学分析方法和病例对照的研究方法,对幼儿园发生的咽结合膜热暴发病例进行发病经过和传播因素的调查,采集患者咽拭子进行病毒分离,核酸鉴定,采集血清进行病毒抗体检测。结果自2004年6月21日～7月19日,幼儿园349名幼儿中共有258人发病,罹患率73.9%。病例分布在不同年级、班别间无差别。流行曲线呈单峰型。在日托幼儿中,参加游泳幼儿的罹患率明显高于未参加游泳的幼儿(X2=28.96,P<0.001),且随游泳次数的增多,罹患率升高。实验室结果,用PCR检测27例病人的咽拭子标本,10份腺病毒基因阳性(37.0%),其中6份进行了基因序列测定,并对获得的基因序列(290bp)进行分析,显示与腺病毒3型同源性达97%,可认为PCR扩增物为3型腺病毒。同时还检出呼吸道合胞病毒、I型副流感病毒等其它病原体。结论此次疫情主要的病原体是腺病毒3型,幼儿主要通过在幼儿园游泳池戏水以及接触传播的途径引起咽结合膜热暴发,同时合并其它多种病原体感染。
OBJECTIVE: To analyze the epidemiological characteristics and prevalence of thermal outbreak of pharyngoalveolar laryngeal synovial virus type 3 infection. Methods By means of descriptive epidemiological analysis and case-control study, the pathogenesis and transmission of pharyngeal conjunctival fever in kindergarten were investigated. Throat swabs were collected for virus isolation and nucleic acid identification. Serum was collected for virus antibody detection . Results From June 21 to July 19, 2004, 258 infants from 349 infants in kindergarten had a total incidence of 73.9%. Cases distributed in different grades, no difference between classes. Pop curve was unimodal. Among the daycare children, the attack rate of young children participating in swimming was significantly higher than that of those without swimming (X2 = 28.96, P <0.001), and the attack rate increased with the increase of swimming times. Laboratory results showed that throat swab samples from 27 patients were detected by PCR and 10 were positive for adenovirus (37.0%). Six of them were sequenced and the obtained gene sequence (290bp) was analyzed. The results showed that Adenovirus type 3 homology of up to 97%, PCR amplification can be considered as type 3 adenovirus. Also detected respiratory syncytial virus, parainfluenza virus type I and other pathogens. Conclusion The main pathogen of the outbreak is adenovirus type 3. Infants mainly induce fever of pharyngo-conjunctiva through bathing and contact with kindergarten swimming pool. In addition, they also incorporate other pathogens.