Study On Risk Factors Of Enteroviral Meningitis And Encephalitis And Dignostic Methods Of Laboratory In Jiangsu Province

Objective: (1) Describing the distribution characteristics of enteroviral meningitis and encephalitis in detail during the three last years in JiangSu Province,and discussing about risk factors of enteroviral meningitis and encephalitis in XuZhou and YangZhou, in order to acquire the basic epidemiological materials of enteroviral meningitis and encephalitis .(2) To make clear the outstanding strains of enteroviral meningitis and encephalitis during the three last years in Jiangsu Province, to discuss about dignostic methods of laboratory and to illustrate the best method of laboratory so as to give a helping hand to clinical doctor for diagnosing the enteroviral meningitis and encephalitis.method: (1) 203 children with meningitis or encephalitis and 406 children with normal,no fever were collected from ten countries and schools during enteroviral meningitis or encephalitis outbreaking in XuZhou and YangZhou. 609 children were conducted to fill the questionary, and then combining with the epidemiological data, risk factors for enteroviral meningitis and encephalitis are analyzed by univariate and multivariate statistical methods and Generalized Estimation Equations (GEE).(2) 102 children's cerebrospinal fluid(CSF) with meningitis or encephalitis were detected by viral culture,Nest-PCR and real-time PCR respectively.By the terms of results,the three methods were compared.Results:(1) Ten significant factors were screened by univariate logistic regression analysis,these factors including eating melon ,eating peach, contacting with the patient before the last two weeks, patient in the neighbors or kins, washing hands, the door and window decorated with the voile, the insect in the dooor, the density of the fly in the door, family sanitation, the poulty or livestock(P﹤0.05). (2) The seven factors were significant by means of multivariate logistic regression analysis, that is eating melon , contacting with the patient before the last two weeks, patient in the neighbors or kins, washing hands, the door and window decorated with the voile, the density of the fly in the door, family sanitation(P﹤0.05). (3) According to multivariate logistic regression analysis,the seven significant factors and area factor were analysed by Generalized Estimation Equations (GEE), that is eating melon , contacting with the patient before the last two weeks, patient in the neighbors or kins, washing hands, the door and window decorated with the voile, the density of the fly in the door, family sanitation(P﹤0.05) and the area(P﹥0.10). (4)In 2001,the serotype of enteroviral meningitis and encephalitis was mainly COXB5, 2002 and 2003 the serotype of enteroviral meningitis and encephalitis were mainly Echo30 in JiangSu province.102 CSF were tested by Nest-PCR and Real-time PCR respectly, the positive rate of EV RNA was 71.57%(73/102),43.14%(44/102) .the sensitivity of Nest-PCR and Real-time PCR respectly is 0.001TCID50 and 0.01TCID50,and the specificity of two methods are 100%.Conclusions: (1) The most effective measures are reducing to contact with the patients and paying attention to santitation of individual and household in order toprevent and control the outbreaking of enteroviral meningitis and encephalitis in JiangSu province. (2) In 2001,the serotype of enteroviral meningitis and encephalitis was mainly COXB5, In 2002 and 2003, the serotype of enteroviral meningitis and encephalitis were mainly Echo30 in JiangSu province.(3) The real-time PCR have the virtue of speediness,convenience,specificity,and quantitative detection,so that it can detect the enterovirus when the enterovirus is outbreaking.But the sensitivity is not as good as Nest-PCR's.