纸坊病病毒病因的研究

1985年4～10月与1986年6～8月,在贵州省沿河县的纸坊村和崔家坨村先后发生了病因不明的传染病。纸坊村约有1/5的村民发病,病死率为12％,崔家坨村有1/10的村民发病,病死率高达30％。发病波及各年龄组,以青壮年为多,有家庭集聚现象。 本病起病急,轻症者只有头晕、乏力、肌痛、多汗、心悸伴以低热,有的初期有短暂的腹泻。重症者有高热(40℃以上)、大汗、心悸、游走性肌肉痉挛伴有明显疼痛和触痛,以腰骶部及四肢肌肉为好发部位。病人烦燥不安,2～5天内死亡。经实验室检查,排除了食物中毒、农药中毒、钩端螺旋体病和弓形体感染。从病人和接触者的粪便中分离到9株病毒,性状一致,为RNA型25nm的球形颗粒,耐酸,耐乙醚,能凝集人“O”型血球。经血清学鉴定为ECHO3型病毒。16份病人双份血清的检测结果表明,恢复期血清对该病毒中和抗体有4倍以上升高者共8例(纸坊村和崔家坨各4例)。病人单份血清也都有较高的抗体。有理由认为两年中先后在两个村庄发生的传染病与ECHO3型病毒有密切关系。查阅文献,尚未见有关ECHO3型病毒引起以肌痛、游走性肌痉挛为特征的疾病的报道。

STUDIES ON THE ETIOLOGY OF "ZHI FANG" DISEASE

An outbreak of a new disease occurring in the period of April to Octo ber in 1985 in "Zhi Fang" village has been reported in this journal (3:95, 1987 ) .Since then, from June to October in 1986, a similar disease outbreak oc-curred in "Cui" village of the same county which was about 50 kilometers away from "Zhi Fang" village. The symptoms of these patients and the pattern of this epidemic were just the same as before.We have isolated a virus from "Cui" village and collected 7 patients' paired sera, of which an antibody titer rise over 4 fold was detected in 4 convalescent patients, others had high titer antibody in single specimens of convalescent serum except orie who was 77 years old.The character of the virus was the same as the 8 strains isolated in 1985. By using neutralization test with standard enterovirus antiserum, these vi ruses were identified as ECHO 3.As the two outbreak occurred in two years in succession in nearby loc-alities, the same virus was isolated, 44% to 57% of the patients paired sera had antibody rise over 4 folds, it is reasonable to consider that disease is closely associated with ECHO 3 virus.We have never known ECHO virus could cause disease like this. The probable pathogenesis of the main symptoms of wandering myoclonus with pain and tenderness was discussed.