杭州市拱墅区一起人偏肺病毒疫情的分子特征分析

Molecular characterization analyses of a human metapneumovirus outbreak in Gongshu District of Hangzhou City

  • 摘要:目的】 研究2024年5月杭州市拱墅区某幼儿园发生的一起人偏肺病毒(HMPV)感染聚集性疫情的流行病学及病原学特点,以期为类似疫情的防控提供参考。【方法】通过流行病学个案调查表开展现场流行病学调查,并采集病例的咽拭子标本,利用实时荧光PCR技术对13种常见呼吸道病毒进行病原筛查。对于检测出HMPV核酸阳性的样本,进一步选取F基因作为靶点进行扩增和测序,并将所得序列与GenBank数据库进行比对,以判定病毒亚型并开展系统进化分析。【结果】 此次疫情发生在小班,全班28名幼儿、3名教师和保育员。共发现病例11例(10名幼儿、1名教师),其中男性8例,女性3例。临床表现为发热11例(100.00%)、咳嗽8例(72.73%)、卡他症状4例(36.36%)、头痛3例(27.27%),症状均较轻,无重症病例。共采集11份咽拭子标本,实时荧光PCR检测结果显示,3份为HMPV核酸阳性,另2份为HMPV和肺炎链球菌同时阳性,1份为HMPV和鼻病毒同时阳性。6份HMPV核酸阳性标本用特定引物扩增并分析序列确定均为HMPV A2b型。F基因片段序列和PV081665.1/Brazil/2024相似性最高(99.65%),和PP683455.1/Indonesia/2021、PV016275.1/Beijing/2024、PV052230.1/USA/2024相似性也较高(依次为99.48%、99.31%、99.13%)。【结论】此次急性呼吸道感染聚集性疫情由HMPV A2b型引起,并伴有鼻病毒、肺炎链球菌混合感染。此次疫情中HMPV的F基因片段序列与巴西、北京、印度尼西亚、美国分离的A2b型毒株序列具有高度同源性。

     

    Abstract: Objective To analyze the epidemiological and etiological characteristics of a cluster of human metapneumovirus (HMPV) infection in a kindergarten in Gongshu District of Hangzhou City in May 2024, and provide reference for the prevention and control of similar outbreaks. Methods An on-site investigation was conducted using an epidemiological case investigation form. Throat swab specimens collected from cases were screened for 13 respiratory pathogens using real-time PCR. For HMPV nucleic acid positive specimens, the F gene of HMPV was used as the target gene for sequence amplification and determination. The sequencing results were compared with sequences in GenBank to determine the virus subtypes and perform phylogenetic analyses. Results The outbreak occurred in a bottom class with a total of 28 preschoolers and 3 teachers and childcare workers., A total of 11 cases were identified, 10 preschoolers and 1 teacher, including 8 male cases and 3 female cases. The clinical features were fever in all 11 cases (100.00%), cough in 8 cases (72.72%), catarrhal symptoms in 4 cases (36.36%), and headache in 3 cases (27.27%). All symptoms were mild, and no severe cases were observed. A total of 11 throat swab samples were collected. Real-time PCR test results showed that 3 samples were positive for HMPV nucleic acid, 2 samples were positive for both HMPV and Streptococcus pneumoniae, and 1 sample was positive for both HMPV and rhinovirus. The sequences of the 6 HMPV nucleic acid positive specimens were amplified and analyzed using specific primers, and all were determined to be HMPV subtype A2b. The F gene fragment sequence showed the highest similarity (99.65%) to PV081665.1/Brazil/2024, and also exhibited high similarity to PP683455.1/Indonesia/2021, PV016275.1/Beijing/2024, and PV052230.1/USA/2024 (99.48%, 99.31%, and 99.13%, respectively). Conclusion This cluster of acute respiratory infection was caused by HMPV subtype A2b, accompanied by mixed infections of rhinovirus and Streptococcus pneumoniae. The F gene fragment sequences of the HMPV in this outbreak were highly homologous to those of the A2b strains isolated in Brazil, Beijing, Indonesia, and the United States.

     

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