高原地区青海省2017-2018年度流感样病例流行病学特征分析
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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.
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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[17]王玉光,谷晓红,马家驹,等.2017-2018年北京地区流行性感冒病证特征及应对策略[J].北京中医药,2018,37(1):3-7.DOI:10.16025/j.1674-1307.2018.01.001.Wang YG,Gu XH,Ma JJ,et al.Characteristics and countermeasures of influenza syndrome in Beijing region from 2017 to2018[J].Beijing J Trad Chin Med,2018,37(1):3-7.DOI:10.16025/j.1674-1307.2018.01.001.
[2]国家卫生计生委办公厅关于印发全国流感监测方案(2017年版)的通知[Z].2017-03-30.The notice of the general office of the national health and family planning commission on the issuance of the national influenza surveillance program(2017 edition)[Z].2017-03-30.
[3]陈实,高超,黄银兰.不同季节划分尺度下巢湖流域气候变化趋势分析[J].长江流域资源与环境,2013,22(5):582-587.Chen S,Gao C,Huang YL.Analysis on climate change trend of Chaohu lake basin under different seasonal division scales[J].Resour Environ Yangtze Basin,2013,22(5):582-587.
[4]中国疾病预防控制中心传染病预防控制处.近期我国流感疫情形势分析(截至2018年2月5日)[Z].2018,6(1):1-8.Department of Infectious Disease Prevention and Control,Chinese Center for Disease Control and Prevention.Analysis of the current situation of influenza epidemic in China(as of February 5,2018)[Z].2018,6(1):1-8.
[5]许晶,张蕾,马萍,等.2010-2016年度陕西省流行性感冒监测分析[J].现代预防医学,2017,44(17):3240-3244.Xu J,Zhang L,Ma P,et al.Surveillance and analysis of influenza in Shanxi province during 2010-2016[J].Modern Prev Med,2017,44(17):3240-3244.
[6]饶华祥,石燕.青海省2010-2012年流感样病例监测分析[J].医学动物防制,2014,30(9):945-947.DOI:10.7629/yxdwfz 201409001.Rao HX,Shi Y.Surveillance and analysis of influenza-like cases in Qinghai province from 2010 to 2012[J].J Med Pest Control,2014,30(9):945-947.DOI:10.7629/yxdwfz201409001.
[7]中国疾病预防控制中心病毒病预防控制所.流感监测周报[Z].2018,482:1-25.National Institute for Viral Disease Prevention and Control,Chinese Center for Disease Control and Prevention.Influenza surveillance weekly report(1 week data)[Z].2018,482:1-25.
[8]耿梦杰,曾令佳,孙婕,等.2017-2018年全国冬春季重点传染病疫情形势分析[J].疾病监测,2018,33(3):179-183.Geng MJ,Zeng LJ,Sun J,et al.Epidemic situation analysis of key infectious diseases in winter and spring of China from 2017 to2018[J].Dis Surveill,2018,33(3):179-183.
[9]陆波,张嫣平,王光俊,等.2005-2013年银川市流感监测结果分析[J].宁夏医科大学报,2014,36(8):898-901.DOI:10.16050/j.cnki.issn1674-6309.2014.08.068.Lu B,Zhang YP,Wang GJ,et al.Analysis of influenza surveillance results in Yinchuan city from 2005 to 2013[J].J Ningxia Med Univ,2014,36(8):898-901.DOI:10.16050/j.cnki.issn1674-6309.2014.08.068.
[10]李焱,吴瑞,黄银娟,等.西安市2010-2014年流感监测结果分析[J].中国卫生检验杂志,2016,26(5):736-741.Li Y,Wu R,Huang YJ,et al.Analysis of influenza surveillance results in xi'an city from 2010 to 2014[J].Chin J Heal Inspect,2016,26(5):736-741.
[11]妥小青,张占林,龚政,等.基于ARIMAX模型的乌鲁木齐市流感样病例预测分析[J].中华疾病控制杂志,2018,22(6):590-593.DOI:10.16462/j.cnki.zhjbkz.2018.06.012.Tuo XQ,Zhang ZL,Gong Z,et al.Prediction and analysis of flulike cases in urumqi based on ARIMAX model[J].Chin J Dis Control Prev,2018,22(6):590-593.DOI:10.16462/j.cnki.zhjbkz.2018.06.012.
[12]黄智峰,刘晓剑,杨连朋,等.深圳市流行性感冒与气象因素的关联性分析[J].中华疾病控制杂志,2017,21(10):1035-1038.DOI:10.16462/j.cnki.zhjbkz.2017.10.016.Huang ZF,Liu XJ,Yang LP,et al.Correlation analysis between influenza and meteorological factors in Shenzhen[J].Chin J Dis Control Prev,2017,21(10):1035-1038.DOI:10.16462/j.cnki.zhjbkz.2017.10.016.
[13]葛爱华,鲍倡俊,祁贤,等.江苏省2009-2012年流感监测结果分析[J].中华疾病控制杂志,2014,18(2):123-126.Ge AH,Bao CJ,Qi X,et al.Analysis of influenza surveillance results in Jiangsu province from 2009 to 2012[J].Chin J Dis Control Prev,2014,18(2):123-126.
[14]吴照春,徐四清,李贤相,等.2016-2017年安庆市度流感监测分析[J].现代预防医学,2017,44(21):4006-4010.Wu ZC,Xu SQ,Li XX,et al.Surveillance and analysis of influenza in anqing city from 2016 to 2017[J].Modern Prev Med,2017,44(21):4006-4010.
[15]郭元吉,程小雯.流行性感冒病毒及实验室技术[M].北京:中国三峡出版社,1997:35.Guo YJ,Cheng XW.Influenza virus and laboratory technology[M].Beijing:China Three Gorges Publishing House,1997:35.
[16]陈涛,杨静,汪立杰,等.2015年中国大陆流行性感冒流行特征分析[J].热带病与寄生虫学,2016,14(1):3-5.DOI:10.3969/j.issn.1672-2302.2016.01.002.Chen T,Yang J,Wang LJ,et al.Epidemiological characteristics of influenza in mainland China in 2015[J].J Trop Dis and Parasitol,2016,14(1):3-5.DOI:10.3969/j.issn.1672-2302.2016.01.002.
[17]王玉光,谷晓红,马家驹,等.2017-2018年北京地区流行性感冒病证特征及应对策略[J].北京中医药,2018,37(1):3-7.DOI:10.16025/j.1674-1307.2018.01.001.Wang YG,Gu XH,Ma JJ,et al.Characteristics and countermeasures of influenza syndrome in Beijing region from 2017 to2018[J].Beijing J Trad Chin Med,2018,37(1):3-7.DOI:10.16025/j.1674-1307.2018.01.001.