摘要
目的分析高原地区青海省2017年第14周~2018年第13周(2017年4月3日~2018年4月1日),流感监测系统中流感样病例监测结果,掌握流感流行实时动态,为科学防控流感提供依据。方法收集分析青海省2017-2018年度流感样病例流行病学及病原学特征。结果2017年第14周~2018年第13周青海省共报告流感样病例26 086例,门急诊病例总数就诊百分比为2. 95%(26 086/884 529); 5岁以下儿童占总报告病例的71. 51%(18 655/26 086);共对11 391份标本进行实时荧光定量聚合酶链式反应检测,阳性1 991份,阳性率为17. 48%(1 991/11 391);前期以H3、H1为主,中期以H3、H1和B型混合出现,后期以B型为主,其中BY为优势毒株;病毒核酸阳性检出率在年龄(X~2=108. 59,P <0. 001)和时间(X~2=1629. 13,P <0. 001)上的差异均有统计学意义(均有P <0. 05);但在性别上的差异无统计学意义(X~2=5. 33,P=0. 021);流感样病例数及流感样病例就诊百分比与流感病毒核酸阳性率呈相关(Pearson相关系数分别为0. 896和0. 699,均有P <0. 001)。结论 16家哨点医院流感样病例及就诊百分比能准确体现青海省流感病毒实际活动水平,报告病例以5岁以下儿童为主;优势毒株交替出现,病毒高峰在12月中旬~次年1月中旬;要加强流行季节5岁以下组人群及发热诊室中流感样病例的监测,强化0岁组中流感样病例标本采集;集体机构要重点疫情防控流感。
Objective To analyze the surveillance results of influenza-like illness( ILI) and investigate the prevalent trend of influenza from 14 th week 2017 to 13 th week 2018( April 3,2017-April 1,2018) in Qinghai Province so as to provide the scientific basis for the development of prevention and control measures. Methods The epidemiological and pathogenic characteristics of influenza-like cases in qinghai province from 14 th week 2017 to 13 th week 2018 were collected and analyzed. Results ILI mainly occurred in winter and spring from 14 th week 2017 to 13 th week 2018,26 086 ILI cases reported in total,accounting for 2. 95%( 26 086/884 529) of total number of outpatients and emergency cases; including 18 655 cases under 5 years old,accounting for 71. 51%; 1 991 cases were detected with positive by real-time RT PCR with the positive rate of 17. 48%( 1 991/11 391),In the early stage,H3 and H1 were the predominate strains and the middle period was mixed with H3,H1 and B,and the latter was dominated by type B. Positive rates of influenza virus testing had no statistical differences in different gender( X~2= 5. 33,P = 0. 021),while with statistical differences in different age and time( X~2= 108. 59,P < 0. 001; X~2= 1 629. 13,P < 0. 001). Number of ILI cases and the percentage in the outpatients was significantly related with influenza virus positive rates( Pearson correlation coefficient was 0. 896 and0. 699,respectively,P < 0. 001). Conclusions Influenza-like cases at sentinel hospital of Qinghai Province can accurately reflect actual activity level. The peak of positive detection of influenza samples in Qinghai province from 14 weeks 2017 to 13 weeks 2018 season was from mid-December to mid-January.The dominant strain of influenza viruses alternated,and the majority of the affected population is mainly in children under 5 years old. In the future,we should strengthen monitoring works in epidemic season,from October to March of next year and focus on the children under 5 years old and the fever clinic. The collection of samples of influenza-like cases in the 0-year-old group should be strengthened,and collective organizations should focus on influenza prevention and control.
引文
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