本文旨在探究上海市麻疹疑似病例的病原谱构成。从2014—2019年的 3 325 份麻疹/风疹阴性咽拭子标本中,挑选 1 197 份标本,利用荧光定量PCR技术检测水痘带状疱疹病毒(VZV)、人细小病毒B19、人类疱疹病毒4型(Epstein Barr virus,EBV)、人单纯疱疹病毒1型(HSV-1)、人疱疹病毒6型(HHV-6)、人疱疹病毒7型(HHV-7)、柯萨奇病毒A16(CA16)、柯萨奇病毒A6型(CA6)、柯萨奇病毒A10型(CA10)、肠道病毒71型(EV71)及其它通用肠道病毒(EV)。结果显示,共检测到9种病毒,总检出率为9.7%,未检出混合感染。EBV检出率最高,为1.8%,其次为人疱疹病毒6型(1.7%)、VZV及人细小病毒B19(各1.3%)。其他EV检出率为0.8%;检出CA6、CA10各7例(0.6%);检出HSV-1共6例(0.5%),CA16有4例(0.3%)。人细小病毒B19、VZV主要在未成年人中检出,EBV、HHV-6、CA16、CA6在成人和未成年人中占比相似。VZV、EBV及HHV-6主要在男性中检出,HSV-1主要在女性中检出。本研究提示,在上海市麻疹疑似病例中,除麻疹病毒、风疹病毒外,还存在EB病毒、HSV-1、细小病毒B19等9种病毒,它们均可能引起类似麻疹症状而被临床诊断为麻疹,临床医师诊断时须注意加以鉴别。
To explore the pathogen spectrum in suspected measles cases in Shanghai from 2014 to 2019, 1 197 pharyngeal swab specimens were collected from 3 325 measles/rubella negative speciments and screened to detect eleven rash fever associated viruses, including varicella-zoster virus, human parvovirus B19, HSV-1, HHV-6, HHV-7, EBV and other enteroviruses by real time PCR. A total of 9 viruses were detected, and the virus detection rate was 9.7% (108/1 197). Mixed infection was not detected. The positive rate of human Epstein-Barr virus was the highest (1.8%), followed by HHV-6 (1.7%), varicella-zoster virus and human parvovirus B19 (1.3% respectively). The positive rate of other EV was 0.8%. CA6 and CA10 were found in 7 cases with a positive rate of 0.6%, respectively. HSV-1 was found in 6 cases, and the positive rate was 0.5%. 4 cases were CA16, and the positive rate was 0.3%. Human parvovirus B19 and VZV were mainly detected in children. EB, HHV-6, CA16 and CA6 were detected in adults and children at similar rates. Human parvovirus B19 and other enteroviruses were mainly detected in adult cases. VZV, EBV and HHV-6 were mainly detected in males, and HSV-1 was mainly detected in females. In addition to measles and rubella, 9 viruses including EBV, HSV-1 and human parvovirus B19, may cause fever and rash symptoms and be clinically diagnosed as measles. More attention should be paid to the clinical diagnosis.