20222023年河北省病毒性脑炎流行特征及病原谱分析

Epidemic characteristics and analyses of pathogen spectrum of viral encephalitis in Hebei Province from 2022 to 2023

  • 摘要:
    目的 探讨河北省病毒性脑炎的流行特点及病原分布特征。
    方法 收集2022—2023年河北省6家监测医院诊断为病毒性脑炎病例的个案信息,并采集其血液或脑脊液标本,应用酶联免疫吸附试验(ELISA)方法检测血清和脑脊液中10种常见病毒的IgM抗体,还应用实时荧光定量聚合酶链反应(real⁃time PCR)方法检测脑脊液标本中10种病原体核酸。
    结果 2022—2023年河北省共报告病毒性脑炎病例410例,男女性别比为1.20∶1;15岁以下年龄组病例占总数的93.66%。全年均有病例报告,3—7月发病数占72.92%(299/410)。410例病例中病原IgM抗体检出阳性的病例为185例,阳性检出率为45.12%。检出最多的病原依次是单纯疱疹病毒(27.56%)、肠道病毒(7.32%)、腮腺炎病毒(5.61%)。单纯疱疹病毒引起的脑炎病例主要发生在春季,肠道病毒引起的脑炎多发生于春夏季,腮腺炎病毒和EB病毒主要集中在3月份,乙型脑炎病毒主要集中在10月份。病原阳性检出病例的男女性别比为1.06∶1(95/90),主要集中在儿童,5~<10岁年龄组占比最高,为61.62%(114/185)。
    结论 河北省病毒性脑炎病例呈现显著的人群及季节特征,病原体存在多样性,优势病原为单纯疱疹病毒、肠道病毒和腮腺炎病毒。建议持续加强病毒性脑炎病原学监测,为临床精准制定抗病毒策略提供科学依据。

     

    Abstract:
    Objective To investigate the epidemiological characteristics and etiological distribution of viral encephalitis in Hebei Province.
    Methods Case information for patients diagnosed with viral encephalitis at 6 sentinel hospitals in Hebei Province from 2022 to 2023 was collected. Blood or cerebrospinal fluid (CSF) samples of the cases were obtained and tested for IgM antibodies against 10 common viruses in both serum and CSF using enzyme-linked immunosorbent assay (ELISA), and CSF samples were additionally measured for nucleic acids of 10 pathogens using real-time fluorescent quantitative polymerase chain reaction (real-time PCR).
    Results From 2022 to 2023, a total of 410 cases of viral encephalitis were reported in Hebei Province, with a male-to-female ratio of 1.20∶1. Patients aged 15 or below accounted for 93.66% of the total cases. Cases were distributed throughout the year, with a relatively higher number of cases from March to July, accounting for 72.92% (299/410). Among the 410 cases, 185 samples were positive for pathogens with the detection rate of 45.12%. The most common pathogens were herpes simplex virus (27.56%), enterovirus (7.32%), and mumps virus (5.61%). Cases of encephalitis caused by herpes simplex virus mainly occured in spring, while those caused by enterovirus mostly occurred in spring and summer. Cases of mumps virus and Epstein-Barr virus (EBV) clustered in March, and cases of Japanese encephalitis virus clustered in October. The male-to-female ratio of positive cases of viral encephalitis was 1.06∶1 (95/90). These cases were predominantly concentrated in children, with the highest proportion in the 5 to <10 years old age group, accounting for 61.62% (114/185).
    Conclusion Cases of viral encephalitis in Hebei Province was characterized by distinct demographic and seasonal characteristics. Pathogens exhibited significant diversity, with herpes simplex virus, enterovirus, and mumps virus being the predominant pathogens. It is recommended to continuously strengthen the etiological surveillance of viral encephalitis to provide a scientific basis for the precise formulation of clinical antiviral strategies.

     

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