目的探讨甘肃省陇南市康县儿童腺病毒7型的流行病学及病原学特征。方法采用统一的流行病学个案调查表对病例进行调查,采集病例咽拭子样本118份,采用实时荧光聚合酶链反应(PCR)方法对流感病毒(influenza virus,Flu)、呼吸道合胞病毒(respiratory syncytial virus,RSV)、呼吸道腺病毒(human adenovirus,HAd V)等12种病原进行初筛检测。对HAd V核酸初筛阳性样本进行病毒分离,并对分离到的病毒株进行Hexon基因片段测序,核酸序列采用ClustalⅩ和Mega 6.0软件进行分析。结果 2014年12月20日至2015年2月2日共报告118例感染病例,均为儿童,年龄最小的仅2个月,最大的11岁,分布在康县21个乡镇中的17个乡镇,<1岁27例,1~岁37例,2~岁40例;>5岁14例,其中男性67人,女性51人,男女性别比为1.31∶1。临床特征以发热、咳嗽、咽痛为主,部分病例伴扁桃体发炎、腹泻等症状。实验室确诊为HAd V感染的有33例,分布在13个乡镇。118例病例咽拭子经实时荧光PCR检测,HAd V阳性33例,流感病毒H3N2阳性7例,RSV阳性6例,HAd V和RSV混合感染2例。HAd V阳性标本用Hep-2细胞分离到病毒18株。中国疾病预防控制中心病毒病预防控制所复核HAdV7 17株,HAdV3 1株,毒株测序结果表明,HAd V7毒株同源性高达100%,所有毒株位于同一分支上。结论该起儿童呼吸道感染疫情的主要病原是HAdV7;疫情初期为H3N2流感病毒感染,后期RSV病毒感染病例使疫情持续时间延长;当地的恶劣气候,医院门诊对发热患者未按要求进行预检分诊,输液大厅、儿科病房等通风条件差,病例拥挤是本次疫情扩散的主要原因。 Objective To investigate the epidemiological and etiological characteristics of children adenovirus type 7 in Kangxian County, Longnan City, Gansu Province. Methods A total of 118 cases of throat swab samples were collected by a unified epidemiological questionnaire. Fluorescent real-time polymerase chain reaction (PCR) was used to detect influenza virus (Flu), respiratory syncytial virus respiratory syncytial virus (RSV) and respiratory tract adenovirus (HAd V). Viruses were isolated from positive samples of primary screening of HAd V nucleic acids. Hexon gene fragments were sequenced for the isolated virus strains. The nucleic acid sequences were analyzed by Clustal X and Mega 6.0 software. Results A total of 118 cases of infection were reported from December 20, 2014 to February 2, 2015, all children. The youngest was only 2 months and the oldest was 11 years old. It was distributed in 17 townships in 21 townships in Kangxian County , <1 year old 27 cases, 1 ~ 37 years old, 2 ~ 40 years old;> 5 years old 14 cases, of which 67 were males and 51 females, male to female ratio was 1.31: 1. Clinical features of fever, cough, sore throat, some cases with tonsillitis, diarrhea and other symptoms. Laboratory confirmed HAd V infection in 33 cases, located in 13 townships. Throat swab in 118 cases was detected by real-time fluorescence PCR. There were 33 cases of HAd V positive, 7 cases of influenza virus H3N2 positive, 6 cases RSV positive and 2 cases of HAd V and RSV mixed infection. HAd V positive specimens using Hep-2 cells isolated 18 strains of viruses. The 17 strains of HAdV7 and 1 strain of HAdV3 were reviewed by the Virus Disease Prevention and Control Center of Chinese Center for Disease Control and Prevention. The sequencing results of the strains showed that the homology of HAd V7 strains was as high as 100% and all the strains were on the same branch. Conclusions The major pathogen of respiratory tract infection in children is HAdV7. In the early stage of the outbreak, the virus is infected with H3N2 influenza virus. In the later stage, the duration of the outbreak of RSV virus infection prolongs. In the severe local climate, the outpatient clinic does not conduct pre-triage of fever patients as required , Infusion room, pediatric wards and poor ventilation conditions, the case of congestion is the main reason for the spread of the epidemic.