| Objectives:1. To analyze the epidemiological characteristics of other infectious diarrhea disease (not including diarrheas caused by cholera, bacillary and amebic dysentery, typhoid and paratyphoid) in Yunnan Province from 2013 to 2015;2. To ducument the distribution characteristics of Rotavirus (RV), Norovirus (NoV), Sapovirus (SaV), Adenovirus (AdV) and Astrovirus (AstV) among 5 years old children with acute diarrhea, and to provide information for therapy, prevention and vaccination of virus diarrhea.3. To identfy epidemic characteristics and strains of norovirus (NoV) and sapovirus (SaV) using molecular biological methods in epidemic area and to provide information for therapy and prevention of diarrhea caused by NoV and NoV.Methods:1. All data were collected from Diseases Reporting Information System, descriptive statistics were used to describe the epidemiological characteristics of other infectious diarrhea disease in Yunnan from 2013 to 2015. Excel and SPSS 22.0 were explored for data analysis.2. A total of 321 chidren’s stools under 5 years old, demographic data andepidemiological information were collectedat First people’s Hospital of Yunnan province and Children’s hospital of Kunming city between July 2014 and June 2015; Add 0.9ml sample diluents and 0.1g or 0.1ml stoolsto 1.5ml EP, and then detect it or keep storage at-20 ℃ after mixing and splitting; RV was detected by enzymelinked immunosorbent assay (ELISA),and then serotype/genotype identified on those positive specimens; AdV was detected by PCR, HuCV and AstV were detected by RT-PCR;Partialsequence of NoV and SaV of the positive samples were amplified by RT-PCR,and then the PCR production were purified,sequenced and put into phylogenetic analysis; The data obtained from the questionnaireand laboratory were entered and analyzed on a desktop computer with the program Epi-Info (version3.1). Statistical analyses were performed using SPSS 17.0. Proportional data were comparedby chi-square or chi-square with Yates correction. A P value of,.05 was considered statistically significant;The sequences were aligned by BLAST to verify the viruses,and then put the representative strains and reference strains into MEGA5.1 software to construct/test neighbor-joining tree.The phylogeny was tested by Bootstrap method,and the No.of bootstap replication was 1000.Reference strains were from GenBank database.Results:1. During 2013-2015,50480 cases of other infectious diarrhea were reported in YunnanProvince,the annual incidence rate was 35.90/lakh.60.83% of patients were Infants below 1 yearsold, and most of cases were scattered residedchildren. The peak season was from November to December.The cases diagnosed by laboratorytesting accounted for 54.50%of the total reported cases.2. During 2014-2015, there were 638 cases.334 cases were children under 5 years of age,and then 13 cases were eliminated.Of the 321 specimens that were collected,98 positive specimens were identified and the prevalence was 30.53%(98/321).RV,HuCV,AstV,AdVand mix infections were detected in 19.31%(62/321),9.03%(29/321),0.31%(1/321),0 and 1.87%(6/321),respectively3. In Kunming,Viral diarrhea mainly occurred in autumn and winter, and children who were under 2 years old were the majority among patients infected by diarrhea viruses.The prevalencerates of RV and HuCV showed no differences between gender, respectively.4. Among 62 HRV positive cases,serotypes G9 and P [8] were the most predominant strains.Typing and phylogenetic analysis revealed that NoV GIIthat accounted for 96.88%was the dominant strains.Conclusions:1. The reported highest incidence of other infectious diarrhea was39.15/lakh in the year of 2015 in Yunnan Province from 2013 to 2015.The diseases mainly occurredin winter; Infants below 1 yearsold were the high-risk population of "the other infectious diarrhea" and should bepriorized to monitor;2. In Kunming,Viral diarrhea mainly occurred in autumn and winter, and the prevalence rates presented no differences between gender,and<24 months infants were the susceptible population.The disease surveillance should be strengthened.3. RV was recognized as the main pathogen responsible for the viral diarrhea cases in Kunming, and the predominant serotype was G9P[8]. The following pathogen was HuCV, and AstV and AdV infection occurred sporadically.4. HuCV, followed rotavirus, was one of the most major pathogens among children with diarrhea, and GII.4/Sydney2012 variant was identified as the predominant strain in Kunming.NoV, as RNA viruses, mutated easily. We should strengthened the surveillance on the diarrhea caused by HuCV (especially NoV) in order to discover new variants in time, and thus taking effective measures to control the disease. |
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