2017年彭州市人感染H7N9禽流感病例流行病学特征分析
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摘要
目的分析2017年成都市彭州市人感染H7N9禽流感病例的流行特征,探讨其临床特征、感染重点人群及危险因素。方法采用流行病学个案调查与描述性分析方法,对彭州市6例确诊病例进行流行病学分析;采用荧光定量PCR方法检测病例、密切接触者及外环境标本H7N9禽流感病毒核酸。结果 6例人感染H7N9禽流感病例的确诊时间为2017-04-19/27,死亡3例,病死率为50%;男性多于女性(5∶1);年龄最小52岁,最大73岁;职业以农民为主(83. 3%);分布在不同的村社;均以发热为首发症状; 50%有慢性基础性疾病;发病前均有活禽相关暴露史; 180名密切接触者均未发现异常; 134份外环境样本中,32份H7N9病毒核酸阳性,阳性检出率为23. 88%。结论中老年男性是成都市彭州市人感染H7N9禽流感病例的危险人群。活禽及活禽市场暴露是人感染H7N9禽流感病毒的关键风险因素。
Objective To analyze the epidemiological characteristics of human infection with avian influenza A( H7 N9) virus in Pengzhou city of Chengdu and to explore the clinical characteristics,infection groups and risk factors. Methods The case studies and descriptive analysis method were used to analyze 6 confirmed H7 N9 cases in Pengzhou. The fluorescent quantitative PCR was used to test the nucleic acid of avian influenza A( H7 N9) virus in cases,patients' close contacts and external environment samples. Results All the 6 H7 N9 cases were diagnosed from April 19 to 27,2017,including 3 deaths,and the case fatality rate was 50%.Among the cases,male was more than female with the sex ratio of 5: 1. The patients were between 52 and 73,and 83. 3% of them were farmers. The cases were distributed in different villages. Fever was the most common initial symptom to be noticed,and 3 of the confirmed cases had other chronic diseases. All of cases had ever exposed to live poultry or contaminated environments before illness onset. All 180 close contacts of the patients showed negative results. In the 134 samples collected from external environments,32 were positive for H7 N9,with a positive rate of 23. 88%. Conclusion The middle-aged and elderly men were the population at high risk of H7 N9 in Pengzhou City of Chengdu. The key risk factors for H7 N9 found to be the exposure to live poultry and live poultry markets.
Objective To analyze the epidemiological characteristics of human infection with avian influenza A( H7 N9) virus in Pengzhou city of Chengdu and to explore the clinical characteristics,infection groups and risk factors. Methods The case studies and descriptive analysis method were used to analyze 6 confirmed H7 N9 cases in Pengzhou. The fluorescent quantitative PCR was used to test the nucleic acid of avian influenza A( H7 N9) virus in cases,patients' close contacts and external environment samples. Results All the 6 H7 N9 cases were diagnosed from April 19 to 27,2017,including 3 deaths,and the case fatality rate was 50%.Among the cases,male was more than female with the sex ratio of 5: 1. The patients were between 52 and 73,and 83. 3% of them were farmers. The cases were distributed in different villages. Fever was the most common initial symptom to be noticed,and 3 of the confirmed cases had other chronic diseases. All of cases had ever exposed to live poultry or contaminated environments before illness onset. All 180 close contacts of the patients showed negative results. In the 134 samples collected from external environments,32 were positive for H7 N9,with a positive rate of 23. 88%. Conclusion The middle-aged and elderly men were the population at high risk of H7 N9 in Pengzhou City of Chengdu. The key risk factors for H7 N9 found to be the exposure to live poultry and live poultry markets.
引文
[1]Gao R,Cao B,Hu Y,et al. Human infection with a novel avian–origin influenza A(H7N9)virus[J]. N Engl J Med,2013,368(20):1888-1897.
[2]Parry J. H7N9 avian flu infects humans for the first time[J]. BMJ,2013,346:f2151.
[3]中华人民共和国国家卫生和计划生育委员会.人感染H7N9禽流感诊疗方案(2017年第一版)[J].中华临床感染病杂志,2017,10(1):1-4.
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[7]韩迪迪,韩春霞,李璐钰,等.中国2013-2017年人感染H7N9禽流感的流行病学特征[J].中华流行病学杂志,2018,39(1):44-46.
[8]曹明华,候赛,龚磊,等.安徽省人感染H7N9禽流感病例临床流行病学分析[J].现代预防医学,2018,45(2):201-203.
[9]亓云鹏,顾伟玲,富小飞,等. 15例人感染H7N9禽流感病例分析[J].预防医学,2016,28(8):785-788.
[10]Gao HN,Lu HZ,Cao B,et al. Clinical findings in 111cases of influenza A(H7N9)virus infection[J]. N Eng J Med,2013,368(24):2277-2285.
[11]闫铁成,肖丹,王波,等.中国大陆130例人感染H7N9禽流感病例流行病学特征分析[J].中华疾病控制杂志,2013,17(8):651-654.
[12]Liu B,Havers F,Chen E,et al. Risk factors for influenza A(H7N9)disease–China,2013[J]. Clin Infect Dis,2014,59(6):787-794.
[13]何林,周小锋,许少坚,等.深圳市龙华新区20呼吸道13-2015年人感染H7N9禽流感发病及监测情况分析[J].实用预防医学,2017,24(6):728-730.
[14]任瑞琦,周蕾,向妮娟,等.中国内地人感染H7N9禽流感疫情流行病学特征分析[J].中华流行病学杂志,2014,35(12):1362-1365.
[15]李硕,张云辉,王永怡,等. 2017年3-4月全球主要疫情回顾[J].传染病信息,2017,30(4):81-82.
[16]秦彦珉,梅树江,谢旭,等.深圳市25例人感染H7N9禽流感确诊病例流行病学分析[J].实用预防医学,2015,22(8):952-955.
[17]Liu S,Sun J,Cai J,et al. Epidemiological,clinical and viral characteristics of fatal cases of human avian influenza A(H7N9)virus in Zhejiang province, China[J]. J Infection,2013,67(6):595-605.
[18]潘琼娇,魏晶娇,余向华,等. 9例人感染H7N9禽流感病例流行病学特征分析[J].疾病监测,2016,31(2):115-119.
[2]Parry J. H7N9 avian flu infects humans for the first time[J]. BMJ,2013,346:f2151.
[3]中华人民共和国国家卫生和计划生育委员会.人感染H7N9禽流感诊疗方案(2017年第一版)[J].中华临床感染病杂志,2017,10(1):1-4.
[4]中华人民共和国国家卫生和计划生育委员会.人感染H7N9禽流感疫情防控方案(第三版)[J].首都公共卫生,2014,8(2):53-55.
[5]中国疾病预防控制中心.人感染H7N9禽流感流行病学调查方案[EB/OL].(2013-06-26)[2018-06-01].http://www. chinacdc. cn/jkzt/crb/zl/rgrgzbxqlgg/rgrglgyh/201306/P020130626350207588624. pdf
[6]中国疾病预防控制中心.人感染H7N9禽流感病毒标本采集及实验室检测策略. http://www. chinacdc. cn/jkzt/crb/zl/rgrgzbxqlgg/rgrglgyh/201306/P020130626350875775253. pdf
[7]韩迪迪,韩春霞,李璐钰,等.中国2013-2017年人感染H7N9禽流感的流行病学特征[J].中华流行病学杂志,2018,39(1):44-46.
[8]曹明华,候赛,龚磊,等.安徽省人感染H7N9禽流感病例临床流行病学分析[J].现代预防医学,2018,45(2):201-203.
[9]亓云鹏,顾伟玲,富小飞,等. 15例人感染H7N9禽流感病例分析[J].预防医学,2016,28(8):785-788.
[10]Gao HN,Lu HZ,Cao B,et al. Clinical findings in 111cases of influenza A(H7N9)virus infection[J]. N Eng J Med,2013,368(24):2277-2285.
[11]闫铁成,肖丹,王波,等.中国大陆130例人感染H7N9禽流感病例流行病学特征分析[J].中华疾病控制杂志,2013,17(8):651-654.
[12]Liu B,Havers F,Chen E,et al. Risk factors for influenza A(H7N9)disease–China,2013[J]. Clin Infect Dis,2014,59(6):787-794.
[13]何林,周小锋,许少坚,等.深圳市龙华新区20呼吸道13-2015年人感染H7N9禽流感发病及监测情况分析[J].实用预防医学,2017,24(6):728-730.
[14]任瑞琦,周蕾,向妮娟,等.中国内地人感染H7N9禽流感疫情流行病学特征分析[J].中华流行病学杂志,2014,35(12):1362-1365.
[15]李硕,张云辉,王永怡,等. 2017年3-4月全球主要疫情回顾[J].传染病信息,2017,30(4):81-82.
[16]秦彦珉,梅树江,谢旭,等.深圳市25例人感染H7N9禽流感确诊病例流行病学分析[J].实用预防医学,2015,22(8):952-955.
[17]Liu S,Sun J,Cai J,et al. Epidemiological,clinical and viral characteristics of fatal cases of human avian influenza A(H7N9)virus in Zhejiang province, China[J]. J Infection,2013,67(6):595-605.
[18]潘琼娇,魏晶娇,余向华,等. 9例人感染H7N9禽流感病例流行病学特征分析[J].疾病监测,2016,31(2):115-119.