2017—2024年北京东北郊区1 150起呼吸道暴发疫情中流感病原学分布及乙型流感病毒分子进化分析

doi:10.12183/j.scjpm.2025.1220

摘要/Abstract

摘要： 目的分析北京东北郊区2017—2024年监测周期中呼吸道暴发疫情的病原学监测情况,了解本地区流感病毒流行特征及乙型流感病毒的进化特点,为流感疫情防控提供依据。方法采集2017—2024监测周期呼吸道暴发疫情中发热病例及流感样病例样本,通过实时荧光定量聚合酶链式反应（qRT-PCR）进行流感病毒核酸检测,使用描述性流行病学方法分析流感病毒流行特征。分层随机选取13株B/Victoria系（BV）流感病毒,采用逆转录聚合酶链式反应（RT-PCR）方法扩增血凝素（hemagglutinin,HA）基因,并进行核苷酸序列测定;同时结合流感共享数据库中收录的乙型流感病毒株HA基因序列,构建系统进化树,研究BV基因特征和遗传进化规律。结果 2017—2024年监测周期共采集呼吸道暴发疫情流感样病例样本6 250份,其中流感病毒核酸阳性3 517份,阳性率为56.27%。2017—2024年流感病毒亚型以A/H3N2为主（55.90%）,其次是A/H1N1（26.81%）,BV（13.14%）及B/Yamagata（4.15%）亚型。2017—2018年监测周期A/H1N1亚型和B型流感病毒共同流行;2018—2019年为A/H1N1、A/H3N2和BV 3种型别流感病毒交替流行;2019—2020年的流行株亚型为A/H3N2;2021—2022年BV亚型为绝对优势流行株;2022—2023年监测周期是以A/H1N1和A/H3N2亚型为主;2023—2024年以A/H3N2和BV 2种型别交替流行。HA系统进化树显示,分离得到的13株BV系流感毒株均属于V1A分支。与同期疫苗株相比,各监测周期流行株在HA蛋白的120环、150环、160环及190螺旋等关键抗原决定簇部位有多个氨基酸位点突变。结论 2017—2024年监测周期内,北京东北郊区呼吸道暴发疫情中流感病毒流行亚型具有多样性。与同期疫苗株相比,BV系流感毒株虽具有较高的同源性,但其遗传多样性增加,且在HA基因多个关键位点发生突变。因此,需对流感的流行特征和分子进化情况开展持续监测,为以流感防控为重点的呼吸道疫情防控提供科学依据。

关键词: 乙型流感病毒, 血凝素基因, 分子进化, 流感样病例

Abstract: Objective To characterize the etiological spectrum of respiratory outbreaks in the northeastern suburbs of Beijing during the 2017-2024 surveillance period, to elucidate local epidemiological patterns of influenza viruses, and to investigate the molecular evolution of influenza B virus, thereby providing an evidence base for influenza prevention and control. Methods Respiratory specimens were collected from febrile and influenza-like illness cases associated with outbreaks between 2017 and 2024. Influenza viral RNA was detected by real-time quantitative PCR (qRT-PCR), and descriptive epidemiological methods were applied to delineate subtype-specific prevalence. Thirteen BV isolates were randomly selected and their hemagglutinin (HA) genes amplified by reverse-transcription PCR (RT-PCR) and sequenced. Together with homologous BV HA sequences retrieved from the GISAID database, maximum-likelihood phylogenies were constructed to infer genetic characteristics and evolutionary dynamics. Results Among 6 250 outbreak-associated specimens, 3 517 were positive for influenza virus, yielding an overall positivity rate of 56.27%. Across the surveillance period, subtype A/H3N2 predominated (55.90%), followed by A/H1N1 (26.81%), BV (13.14%), and B/Yamagata (4.15%). Co-circulation of A/H1N1 and influenza B viruses was observed in 2017-2018;alternating circulation of A/H1N1, A/H3N2, and BV in 2018-2019;exclusive dominance of A/H3N2 in 2019-2020;overwhelming predominance of BV in 2021-2022;joint dominance of A/H1N1 and A/H3N2 in 2022-2023;and alternating dominance of A/H3N2 and BV in 2023-2024. Phylogenetic analysis revealed that all 13 BV isolates clustered within the V1A clade. Relative to contemporary vaccine strains, outbreak isolates accumulated multiple amino-acid substitutions in critical antigenic regions of the HA protein, including the 120-, 150-, and 160-loops and the 190-helix. Conclusions From 2017 to 2024, influenza outbreaks in northeastern Beijing exhibited considerable subtype heterogeneity. Although BV outbreak strains maintained high overall homology with corresponding vaccine strains, they displayed increasing genetic diversity and acquired mutations at several pivotal HA antigenic sites. Continuous surveillance of both epidemiological trends and molecular evolution is therefore imperative to inform evidence-based respiratory-disease control strategies with emphasis on influenza.

Key words: Influenza B virus, Hemagglutinin gene, Molecular evolution, Influenza-like illness

中图分类号:

R183.3

李湛, 何牧, 王彦波, 贾楠, 张赫, 赵宇, 荆红波. 2017—2024年北京东北郊区1 150起呼吸道暴发疫情中流感病原学分布及乙型流感病毒分子进化分析[J]. 华南预防医学, 2025, 51(11): 1220-1226.

LI Zhan, HE Mu, WANG Yanbo, JIA Nan, ZHANG He, ZHAO Yu, JING Hongbo. Etiological distribution of influenza viruses in 1 150 respiratory outbreaks and molecular evolution of influenza B virus in northeastern Beijing, 2017-2024[J]. South China Journal of Preventive Medicine, 2025, 51(11): 1220-1226.

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