Recurrence of Japanese encephalitis epidemic in Wuhan, China, 2009-2010.
Recurrence of Japanese encephalitis epidemic in Wuhan, China, 2009-2010.
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DOI：
10.1371/journal.pone.0052687
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Zheng X
中科院分区：
文献类型：
--
作者：
Hu Q;Chen B;Zhu Z;Tian J;Zhou Y;Zhang X;Zheng X
流行性乙型脑炎（乙脑）曾在我国大部分地区流行，武汉市也是其中之一。乙脑减毒活疫苗接种后，乙脑发病率明显下降，武汉市2005-2008年未发生乙脑病例。2009年和2010年，这一地区再次发生了31起乙脑病例。在这项研究中，我们调查了乙脑复发的原因。所有乙脑病例均通过IgM捕获酶联免疫吸附试验（ELISA）检测乙脑特异性IgM抗体进行实验室确诊。所有患者均为2个月至9岁的儿童，中位年龄为2岁。在31例病例中，9例曾接种过1 ~ 2剂乙脑疫苗，11例既往未接种过乙脑疫苗，11例免疫史不详。通过逆转录聚合酶链反应（RT-PCR）、序列测定和系统发育分析，从三带喙库蚊体内分离到2株JEV，经鉴定为基因1型，而非以往流行的基因3型。疫苗接种失败或错过接种可能导致乙脑复发。地方疾病控制和预防中心需要提高免疫覆盖率，需要重新评估乙脑疫苗在疾病风险人群中的有效性。
Japanese encephalitis (JE) was once epidemic in most areas of China, including Wuhan, a city located in the central part of China. The incidence of JE dramatically decreased due to nationwide immunization with the live attenuated JE virus (JEV) vaccine, and no JE cases were reported during 2005–2008 in Wuhan. In 2009 and 2010, 31 JE cases reoccurred in this area. In this study, we investigated the causes of JE recurrence. All JE cases were laboratory-confirmed by detecting the JEV-specific IgM antibody with an IgM-capture enzyme-linked immunosorbent assay (ELISA). All patients were children between 2 months and 9 years of age with a median age of 2 years. Of the 31 cases, 9 had received one or two doses of the JEV vaccine, 11 had not been immunized previously with the JEV vaccine, and 11 had an unclear immunization history. Through reverse transcription polymerase chain reaction (RT-PCR), sequencing, and phylogenetic analysis, two new strains of JEV were isolated from Culex tritaeniorhynchus and identified as genotype 1 JEV, rather than genotype 3, which circulated in this area previously. Vaccine failure or missed vaccination may have caused JE recurrence. Local centers for disease control and prevention need to improve immunization coverage, and the efficacy of the JE vaccine needs to be reevaluated in a population at risk for disease.
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