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目的评价中国(未包括香港、澳门特别行政区和台湾地区)2014年麻疹风疹实验室网络(Measles and Rubella Laboratory Network,MRLN)的运转状况。方法分析2014年中国麻疹监测信息报告管理系统中的实验室数据和全国MRLN监测数据,评价中国MRLN运转的各项指标。结果在血清学检测方面,2014年全国共采集散发监测病例血标本103 983例,标本采集率96.11%;实验室确诊麻疹病例为48 344例,占监测病例的37.90%。共证实麻疹暴发276起、风疹暴发7起。在麻疹暴发中,256起(92.75%)经实验室确诊;213起(77.17%)采集了病原学标本。在病毒学监测方面,2014年30个省级麻疹风疹实验室(Measles and Rubella Laboratory,MRL)共送检麻疹病毒4 919株,其中4 872株为中国本土流行的H1a基因亚型,其余为10株B3、3株D8、9株D9、1株G3和24株A基因型(疫苗相关株);15个省级MRL共送检210株阳性风疹病毒,其中74株1E基因型,135株2B基因型和1株2A基因型。在质量控制方面,国家MRL作为世界卫生组织(WHO)西太平洋区麻疹风疹参比实验室,在2014年通过了WHO的职能考核和现场认证;同时陕西、山东、云南、贵州、山西、江西、辽宁和青海8个省级MRL通过了WHO专家组的现场认证;32个省级MRL全部通过了由WHO和国家MRL组织的职能考核。结论中国2014年MRLN运转良好,为监测病例的实验室诊断和鉴别诊断、麻疹和风疹病毒学的监测提供了良好的技术平台,证实本土麻疹基因型H1仍在持续循环流行,同时有4个基因型病毒多次从国外输入,提示加强监测阻断输入病毒传播势在必行。
Objective To evaluate the operational status of the 2014 Measles and Rubella Laboratory Network (MRLN) in China (excluding Hong Kong, Macau Special Administrative Region and Taiwan). Methods Analyze the laboratory data and the national MRLN monitoring data in 2014 China measles monitoring information report management system to evaluate the indicators of the operation of China MRLN. Results In the serological test, 103 983 cases of blood samples were collected and distributed in the whole country in 2014, the sample collection rate was 96.11%. There were 48 344 laboratory measles cases, accounting for 37.90% of the monitored cases. A total of 276 measles outbreaks were confirmed and 7 were reported. Of the measles outbreaks, 256 (92.75%) were laboratory-confirmed and 213 (77.17%) were etiologic specimens. In virological monitoring, a total of 4 919 measles viruses were sent out by 30 provincial Measles and Rubella Laboratory laboratories in 2014, of which 4872 strains were endemic to China and the rest were 10 Strain B3, strain D8, strain D9, strain D9, strain G3 and strain 24 (vaccine-associated strain) of 24 strains. Of the 15 provincial-level MRLs, 210 were positive for rubella virus, of which 74 were 1E genotypes and 135 were 2B Genotype and 1 genotype 2A. In terms of quality control, the MRL, as the reference laboratory for measles and rubella in the Western Pacific Region of the World Health Organization (WHO), passed the functional examination and site certification of WHO in 2014; meanwhile, the MRLs of Shaanxi, Shandong, Yunnan, Guizhou, Shanxi, Jiangxi, MRLs at the eight provincial levels in Liaoning and Qinghai passed on-site certification by the WHO expert group; all MRLs at the provincial level passed the functional examination organized by WHO and the national MRL. Conclusion China’s MRLN was working well in 2014, providing a good technical platform for the monitoring of laboratory diagnosis and differential diagnosis of measles cases and measles and rubella virology. It confirmed that the local measles genotype H1 is still circulating and there are 4 genes Type virus repeatedly imported from abroad, suggesting that strengthening surveillance to block the transmission of imported viruses is imperative.