本文選題：內(nèi)蒙古　切入點：流行性乙型腦炎　出處：《中國疾病預(yù)防控制中心》2009年碩士論文　論文類型：學(xué)位論文

【摘要】： 流行性乙型腦炎(乙腦)是感染乙腦病毒引起的急性傳染性疾病,蚊蟲為傳播媒介。乙腦的病死率約為5-30%,幸存者約30-50%留有嚴重神經(jīng)系統(tǒng)后遺癥,給社會和家庭造成沉重負擔(dān)。乙腦主要流行于亞洲和太平洋地區(qū),我國是乙腦流行的主要國家之一。 我國內(nèi)蒙古自治區(qū)(內(nèi)蒙古)曾是乙腦的高流行區(qū),歷史上曾發(fā)生多次爆發(fā)流行,近十年來乙腦病例明顯減少。本研究收集了內(nèi)蒙古1950-2007年乙腦病例資料進行分析,同時于2007和2008年在內(nèi)蒙古東部、中部和西部連續(xù)兩年采集蚊蟲標本開展病原學(xué)調(diào)查,以期了解當(dāng)?shù)匾夷X流行病學(xué)特征與乙腦及蚊傳蟲媒病毒的流行情況,結(jié)果報告如下。 一、1950-2007年內(nèi)蒙古乙腦流行病學(xué)特征分析 本研究采用描述流行病學(xué)方法,系統(tǒng)分析了內(nèi)蒙古自治區(qū)1950-2007年乙腦流行病學(xué)特征,結(jié)果顯示: (1) 1950-2007年間內(nèi)蒙古共報告乙腦4850例,歷史上發(fā)生多次爆發(fā)流行,其中1974年乙腦發(fā)病率和死亡率為最高,分別為9.66/10萬和1.51/10萬; (2)根據(jù)歷年乙腦發(fā)病的高低可將內(nèi)蒙古乙腦的流行劃分為三個時期:1950-1968年、1969-1984年和1985-2007年。1950-1968年間乙腦平均發(fā)病率為0.07/10萬,1969-1984年間乙腦多次爆發(fā)流行,平均發(fā)病率為1.55/10萬,1985-2007年間乙腦平均發(fā)病率為0.08/10萬。1990年至2007年內(nèi)蒙古乙腦發(fā)病率均低于全國同期乙腦發(fā)病率水平; (3) 1950-2007年間內(nèi)蒙古12個盟市中的10個盟市有乙腦病例報告,烏海市和阿拉善盟從未有乙腦病例報告。報告病例較多的地區(qū)為赤峰市和通遼市,占內(nèi)蒙古乙腦總例數(shù)84.8%。赤峰市和通遼市的報告病例主要集中在1969-1984年; (4)內(nèi)蒙古乙腦發(fā)病具有明顯的季節(jié)特征,每年7月發(fā)病人數(shù)開始上升,病例主要集中在每年8、9月,10月病例顯著下降。與全國和南方的貴州省相比,內(nèi)蒙古乙腦發(fā)病高峰季節(jié)錯后1個月(全國和貴州7、8月為高發(fā)期);與我國北方寧夏回族自治區(qū)的乙腦發(fā)病高峰季節(jié)相似,均為8、9月份; (5) 1988-2007年間乙腦發(fā)病人群性別、年齡分析特征如下:1988-2007年間乙腦報告病例中男女性別比為1:0.48,男性明顯多于女性;各年齡組均有乙腦病例報告,其中15歲以下兒童占發(fā)病總數(shù)28.61%,明顯低于全國平均水平(88.03%); (6) 1991-2007年間乙腦病例職業(yè)分布以農(nóng)民(47.71%)、學(xué)生(23.85%)和散居兒童(8.72%)為主,而全國乙腦病例職業(yè)分布以散居兒童(51.7%)、學(xué)生(26.2%)和托幼兒童(10.9%)為主。 二、內(nèi)蒙古乙腦及蚊傳蟲媒病毒病原學(xué)調(diào)查 為了解內(nèi)蒙古乙腦病毒及蚊傳蟲媒病毒的分布情況,我們選擇內(nèi)蒙古東、中、西部4個標本采集地連續(xù)兩年開展蚊蟲媒介和蚊傳蟲媒病毒的調(diào)查。 1、蚊蟲媒介調(diào)查 2007和2008年7-8月在內(nèi)蒙古通遼市、巴彥淖爾市、呼和浩特市和烏海市的11個旗縣采集蚊蟲標本,共采集到蚊蟲3屬7種共10542只。蚊種包括庫蚊屬兇小庫蚊、淡色庫蚊,伊蚊屬刺擾伊蚊、背點伊蚊、里海伊蚊、黃背伊蚊和按蚊屬中華按蚊。各地的優(yōu)勢蚊種有所差別,通遼市以背點伊蚊為優(yōu)勢蚊種,巴彥淖爾市以里海伊蚊為優(yōu)勢蚊種,呼和浩特市兇小庫蚊與背點伊蚊為優(yōu)勢蚊種,烏海市以黃背伊蚊為優(yōu)勢蚊種。兩年采集時間內(nèi)均未采集到乙腦病毒的主要傳播媒介三帶喙庫蚊。 2、病毒的分離與鑒定 全部蚊蟲標本按每批25～100只經(jīng)過研磨,離心后,接種組織培養(yǎng)細胞(C6/36和BHK-21細胞)進行病毒分離。在呼和浩特市的兇小庫蚊、背點伊蚊,通遼市兇小庫蚊和巴彥淖爾市里海伊蚊中共分離到6株可以引起細胞病變的陽性病毒分離物。病毒分離物通過血清學(xué)(ELISA試驗、間接免疫熒光試驗),分子生物學(xué)(聚丙烯酰胺凝膠電泳試驗、Real-time PCR試驗和RT-PCR等)和生物信息學(xué)等方法的研究,結(jié)果顯示2株病毒為布尼亞病毒科的Tahyna病毒,這是繼我國首次(2006年)在新疆分離到Tahyna病毒后,再次分離到該病毒;1株病毒分離物為呼腸孤病毒科的版納病毒,這是首次在內(nèi)蒙古地區(qū)蚊蟲中分離到版納病毒;3株病毒分離物為細小病毒科Brevidensovirus屬的淡色庫蚊濃核病毒(Culexpipiens pallens Densovirus),這是在內(nèi)蒙古首次從蚊蟲中分離到該病毒。陽性分離物中未鑒定出乙腦病毒。 三、其它工作 本研究還于2008年在遼寧省錦州和丹東市開展了蚊蟲和蚊傳蟲媒病毒調(diào)查。在遼寧省錦州市和丹東市共采集蚊蟲標本,采集到蚊蟲3屬5種共9296只。蚊種包括庫蚊屬三帶喙庫蚊、淡色庫蚊;伊蚊屬背點伊蚊、刺擾伊蚊和按蚊屬中華按蚊。丹東東港市以三帶喙庫蚊為優(yōu)勢蚊種,錦州北寧市以中華按蚊為優(yōu)勢蚊種。在丹東采集的三帶喙庫蚊和錦州的中華按蚊標本中獲得4株病毒分離物,經(jīng)過血清學(xué)和分子生物學(xué)試驗鑒定為1株乙腦病毒,2株版納病毒,1株為版納病毒和遼寧病毒的混合株。新分離乙腦病毒全基因組序列進化分析顯示,2008年在丹東蚊蟲中分離的乙腦病毒與2002年和2007年在該地分離的病毒同屬于基因Ⅰ型乙腦病毒,表明遼寧省丹東市持續(xù)存在基因Ⅰ型乙腦病毒。2008年乙腦病毒分離株與乙腦疫苗株(SA14-14-2株)病毒在E蛋白基因區(qū)段相比,決定病毒毒力和抗原性的關(guān)鍵氨基酸位點沒有變化。 小結(jié) 本研究對內(nèi)蒙古1950-2007年乙腦報告病例的流行病學(xué)資料進行了描述性分析,探討了當(dāng)?shù)匾夷X發(fā)病的流行病學(xué)特征,內(nèi)蒙古乙腦病例主要集中在赤峰市和通遼市,發(fā)病季節(jié)高峰為8、9月,發(fā)病人群以農(nóng)民、學(xué)生、散居兒童為主。這些數(shù)據(jù)為當(dāng)?shù)赜行ьA(yù)防控制乙腦的流行提供了科學(xué)依據(jù)。 本研究對內(nèi)蒙古4個盟市進行了連續(xù)兩年的蟲媒病毒病原學(xué)調(diào)查,首次在內(nèi)蒙古蚊蟲標本分離到Tahyna病毒、版納病毒和淡色庫蚊濃核病毒。本調(diào)查結(jié)果揭示了當(dāng)?shù)匚脗飨x媒病毒的多樣性,提示當(dāng)?shù)乜赡艽嬖诓寄醽啿《究撇《靖腥镜?應(yīng)加強對當(dāng)?shù)叵x媒病毒病檢測與監(jiān)測。
[Abstract]:Japanese encephalitis (JE) is an acute infectious disease caused by Japanese encephalitis virus infection, mosquito media. The mortality of JE is about 5-30%, about 30-50% of survivors have serious neurological sequelae, causing heavy burden to society and family. JE is popular mainly in the Asia Pacific region, China is one of the major countries of JE popular.
China the Inner Mongolia Autonomous Region (Inner Mongolia) was a high prevalence of JE, outbreaks had occurred repeatedly in the history, nearly ten years of Japanese encephalitis were significantly reduced. This study collected 1950-2007 years of Inner Mongolia JE cases were analyzed, at the same time in 2007 and 2008 in the eastern part of Inner Mongolia, central and Western mosquito samples were collected for two consecutive years to carry out the pathogen the investigation, in order to understand the prevalence and epidemiological characteristics of Japanese encephalitis and local JE mosquito borne virus, results are reported.
Analysis of epidemiological characteristics of encephalitis B in Inner Mongolia in the first and 1950-2007 years
In this study, descriptive epidemiological methods were used to systematically analyze the epidemiological characteristics of the 1950-2007 years in the Inner Mongolia Autonomous Region. The results showed that:
(1) in the 1950-2007 years, a total of 4850 cases of JE were reported in Inner Mongolia in the past 1950-2007 years. There were many outbreaks in history. In 1974, the incidence and mortality of encephalitis B were the highest, which were 9.66/10 Vanward and ten thousand, respectively.
(2) according to the level of the incidence of Japanese encephalitis can be popular in Inner Mongolia is divided into three periods: the Japanese for 1950-1968 years, 1969-1984 years and 1985-2007 years.1950-1968 years average JE incidence rate of 0.07/10 million, 1969-1984 years of Japanese encephalitis several outbreaks, the average incidence rate was 100 thousand 1.55/, average 1985-2007 years of JE incidence rate of 0.08/10 million.1990 to 2007 Inner Mongolia JE incidence were lower than in the same period the incidence rate of je;
(3) 10 cities in 12 cities of Inner Mongolia 1950-2007 years of Japanese encephalitis case report, Wuhai and Alashan have reported cases of JE cases report. More area for Chifeng city and Tongliao City, Inner Mongolia accounted for the total number of cases of JE 84.8%. Chifeng city and Tongliao City reported cases are mainly concentrated in 1969-1984 years;
(4) the incidence of Japanese encephalitis in Inner Mongolia has obvious seasonal characteristics, the incidence in July began to rise, the cases were mainly concentrated in 8,9 months each year, October was significantly decreased. Compared with the whole country and the southern province of Guizhou, Inner Mongolia for 1 months the incidence peak season after the fault (national and Guizhou 7,8 month period); similar the Ningxia Hui Autonomous Region North China the incidence peak season was 8,9 months;
(5) sex 1988-2007 years JE incidence, age gender analysis features are as follows: 1988-2007 years of reported cases of JE than for the 1:0.48, there were more males than females; the various age group JE case report, including children under the age of 15 accounted for 28.61%, significantly lower than the national average level (88.03%);
(6) 1991-2007 JE cases in the occupation of farmers (47.71%), students (23.85%) and children (8.72%), and the national occupation in the distribution of JE cases scattered children (51.7%), (26.2%) students and kindergarten children (10.9%).
Two, investigation of Inner Mongolia encephalitis and mosquito borne arbovirus etiology
In order to understand the distribution of Inner Mongolia encephalitis virus and mosquito borne virus, we choose Inner Mongolia East, west 4 specimen collection for two consecutive years to carry out mosquito and mosquito borne arbovirus survey.
1, mosquito vector survey
In 2007 and 2008 7-8 months in Inner Mongolia, Tongliao City, Bayannaoer City, Hohhot city and Wuhai city 11 counties of mosquitoes were collected, were collected from 3 genera and 7 species of mosquitoes. A total of 10542 mosquito species including Culex cx.modestus, Culex pipiens pallens, Aedes ae.vexans, Aedes dorsalis, hay in mosquitoes. Yellow back Aedes and Anopheles sinensis. The dominant species vary across the Tongliao city to ae.dorsalis were the dominant species in the Caspian Sea, Bayannaoer city was the predominant species of Aedes, Hohhot cx.modestus and ae.dorsalis were the dominant species in Wuhai City, yellow back Aedes aegypti were dominant species. Two years the acquisition time were not collected in the main media of Japanese encephalitis virus three Culex.
2, isolation and identification of virus
All the mosquitoes collected according to each batch of 25~100 after grinding, after centrifugation, inoculated into tissue culture cells (C6/36 cells and BHK-21 cells) were isolated. In the city of Hohhot cx.modestus, ae.dorsalis cx.modestus, Tongliao city and Bayannaoer City, the isolated 6 strains of Aedes mosquitoes can cause positive virus cytopathic isolates. Virus isolates by serological (ELISA test, indirect immunofluorescence test), molecular biology (polyacrylamide gel electrophoresis test, Real-time PCR test and RT-PCR) research and bioinformatics method, the results showed that Tahyna virus strain 2 virus of Bunyaviridae, this is the first time in China (2006) in Xinjiang isolation of Tahyna virus, the virus isolated again; 1 strains of the virus isolate reovirus of Banna virus, which was first isolated in the Inner Mongolia area of Banna virus in mosquitoes; 3 strains The virus isolate is Culexpipiens pallens Densovirus of the genus Brevidensovirus of the parvovirus family. It was first isolated from mosquitoes in Inner Mongolia.
Three, other work
This study also on 2008 in Liaoning, Jinzhou province and Dandong city to carry out the investigation of mosquito and mosquito borne arbovirus. Mosquitoes were collected from Jinzhou city in Liaoning province and Dandong City, 3 genera and 5 species of mosquitoes collected a total of 9296 species including three. Culex mosquitoes, Culex pipiens pallens; Aedes genus Aedes dorsalis. Aedes vexans and Anopheles sinensis in Dandong city of Donggang in three. Culex tritaeniorhynchus was the dominant species in Jinzhou, Beining City Anopheles sinensis was the dominant species. 4 strains of the virus was collected in Dandong three Culex and Anopheles sinensis in Jinzhou isolates by serological and molecular biological test for 1 Japanese encephalitis virus strains, 2 strains of Banna virus, 1 strains of Banna virus and Liaoning virus. Mixed strains of Japanese encephalitis virus isolated from whole genome sequence evolution analysis showed that in 2008 in Dandong in the separation of Japanese encephalitis virus and mosquito in 2002 and 2007 in the separation The virus belonged to the genotype of Japanese encephalitis virus, Liaoning city of Dandong province showed that persistent strains and JE vaccine strains isolated JEV.2008 of Japanese encephalitis virus (SA14-14-2 strain) virus was compared in E gene segment, key amino acids to determine the virulence and antigenicity of no change.
Summary
Epidemiological data of Inner Mongolia 1950-2007 years of JE cases in this study were descriptive analysis, discusses the epidemiological characteristics of local incidence, Inner Mongolia JE cases were mainly concentrated in Chifeng city and Tongliao City, the peak seasons for 8,9 months, the incidence in farmers, students, scattered children. These data provide a scientific basis for the local effective prevention and control of JE epidemic.
The study of 4 cities of Inner Mongolia for two consecutive years of investigation of arbovirus pathogens, Tahyna virus was first isolated in Inner Mongolia mosquito specimens, Banna virus and culexpipienspailensdensovirus. The results revealed the diversity of local mosquito borne virus, suggesting possible Bunyaviridae infection, should strengthen the the detection and monitoring of local arbovirus diseases.

【學(xué)位授予單位】：中國疾病預(yù)防控制中心
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2009
【分類號】：R181.3;R512.32

【參考文獻】

相關(guān)期刊論文 前10條

1 徐普庭,王逸民,左建民,林靜雯,徐丕模;從云南省無名熱病人和腦炎病人分離到新環(huán)狀病毒[J];病毒學(xué)報;1990年01期

2 游志勇,王逸民,趙治國,何英,徐普庭,趙子江,陳玉本,陳文洲,張鴻飛;海南省兩株環(huán)狀病毒的分離與鑒定[J];病毒學(xué)報;1990年03期

3 徐普庭,王逸民,龔正達,趙子江,張合潤;從云南省蚊體和無名熱病人發(fā)現(xiàn)另一種新環(huán)狀病毒[J];病毒學(xué)報;1992年02期

4 梁國棟,李其平,何英,陳伯權(quán),謝杏初,陳立,趙子江,黃軼軍,郅琦,馬麗,巴特,阿布里克木;我國首次分離到辛德畢斯病毒[J];病毒學(xué)報;1993年01期

5 呂新軍,付士紅,楊益良,何海懷,張桂筠,陳相偉,梁國棟;我國分離的XJ-90260病毒鑒定為西方馬腦炎病毒[J];病毒學(xué)報;2001年04期

6 李曉宇,宋宏,付士紅,王環(huán)宇,俞永新,董關(guān)木,陶三菊,陳端,Ichiro Kurane,梁國棟;中國流行性乙型腦炎病毒分子生物學(xué)特性研究[J];病毒學(xué)報;2004年03期

7 李其平,謝杏初,郅琦,馬麗,阿不力克木·阿不都熱西提,劉永德,烏守巴特·黨正,張云君,也爾肯·哈山,王誠,斯拉木江·哈馬太,染國棟,何英,趙子江,陳伯權(quán),徐普庭,左建民;首次從新疆無名熱病人分離到8株新環(huán)狀病毒(BANNA)[J];地方病通報;1992年01期

8 張彥平;李林村;吳振溢;郭萬申;王文周;夏占國;趙琢金;岳梅軍;;河南省流行性乙型腦炎地理流行病學(xué)研究[J];河南醫(yī)學(xué)研究;1997年01期

9 張彤,秦毅強,張鶴齡,張麗英,郭志榮;日本腦炎病毒(JEV)內(nèi)蒙古分離株M73-1E基因的5′端克隆及部分序列分析[J];內(nèi)蒙古大學(xué)學(xué)報(自然科學(xué)版);2000年05期

10 劉小強,武建強,張麗,李充璧,方天祺;藍舌病病毒內(nèi)蒙古分離株VP_2基因5′端序列分析及探針制備[J];內(nèi)蒙古大學(xué)學(xué)報(自然科學(xué)版);2004年01期

，

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