乌鲁木齐市2017年2起人感染H7N9禽流感疫情分析
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摘要
目的对乌鲁木齐市2017年监测发现的2例人感染H7N9禽流感病例疫情进行调查分析,为人禽流感疫情防控提供有效参考依据。方法对患者、密切接触者和活禽市场开展流行病学调查,采集病例呼吸道标本和外环境标本应用实时荧光定量PCR (real-time PCR)方法,检测甲型流感病毒及H7N9禽流感病毒特异的核酸片段,进行分析。结果调查发现2例毫无关系患者同一天发热,先后检测出H7N9流感病毒核酸。2例患者均为男性,年龄相近,都有基础性疾病,经过救治,其中1例患者核酸检测转阴,症状消失救治成功。另1例患者核酸检测持续阳性,最终救治无效死亡。流行病学调查患者发病前7天均无活禽接触史,有相同的活禽宰杀点暴露史,经外环境采样,多份标本检测出禽流感病毒核酸。结论 2例感染H7N9禽流感病例感染来源于受H7N9病毒污染的活禽宰杀店的可能性较大,建议加强沿街商铺的规范管理和卫生消毒工作,规范禽类宰杀与销售。医疗机构加强流感样病例监测和不明原因肺炎监测是及时发现人禽流感病例的重要手段。
Objective To investigate and analyze two cases of human infections with avian influenza A(H9 N2) virus reported in Urumchi 2017, so as to provide a better basis for the prevention and control of avian influenza infection in human.Methods The case and close contacts were surveyed,and samples from patients, close contacts and external environment were collected and tested by real-time PCR for nucleic acids of influenza A(H7N9) virus.Results Two patients who had no relationship had flu symptoms on the same day, and confirmed to be infected with human avian influenza A(H7N9) virus on the same day, H7N9 pathogens were detected one after another. The two patients were male, with similar age and both had the history of chronic diseases. After treatment, the nucleic acid test results of A patients turned negative, and the symptoms disappeared. Another patient eventually died despite the treatment was given. Two cases had exposure history to a farm produce market but no history of exposure to alive poultry within 7 days. The positive samples of H7N9 viral nucleic acid were detectedat killed poultry stalls.Conclusion It was highly possible that the cases were infected in the same farm produce market contaminated by H7N9 virus, indicating that health management and disinfection in farm produce market need to be strengthened, and poultry slaughtering and sale procedure need to be standardized. The monitoring of pneumonia of unknown etiology and influenza-like cases in medical institutions is the important means to find timely cases of human infected with avian influenza.
Objective To investigate and analyze two cases of human infections with avian influenza A(H9 N2) virus reported in Urumchi 2017, so as to provide a better basis for the prevention and control of avian influenza infection in human.Methods The case and close contacts were surveyed,and samples from patients, close contacts and external environment were collected and tested by real-time PCR for nucleic acids of influenza A(H7N9) virus.Results Two patients who had no relationship had flu symptoms on the same day, and confirmed to be infected with human avian influenza A(H7N9) virus on the same day, H7N9 pathogens were detected one after another. The two patients were male, with similar age and both had the history of chronic diseases. After treatment, the nucleic acid test results of A patients turned negative, and the symptoms disappeared. Another patient eventually died despite the treatment was given. Two cases had exposure history to a farm produce market but no history of exposure to alive poultry within 7 days. The positive samples of H7N9 viral nucleic acid were detectedat killed poultry stalls.Conclusion It was highly possible that the cases were infected in the same farm produce market contaminated by H7N9 virus, indicating that health management and disinfection in farm produce market need to be strengthened, and poultry slaughtering and sale procedure need to be standardized. The monitoring of pneumonia of unknown etiology and influenza-like cases in medical institutions is the important means to find timely cases of human infected with avian influenza.
引文
[1]韩迪迪,韩春霞,李璐钰,等.中国2013-2017年人流感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.
[2]高枫,阿不都热依木·阿布都克里木,樊旭成,等.乌鲁木齐市1例人感染H7N9禽流感确诊病例的调查处理[J].中国热带医学,2016,16(3):294-296
[3]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)[C].2014.01.29.
[4]王琦梅,刘社兰,陈恩富.人感染H7N9禽流感流行病学研究进展[J].中华预防医学杂志,2017,51(2):183-187.
[5]国家卫生和计划生育委员会.人感染H7N9禽流感诊疗方案[C].2017.01.001.
[6]胡晓申,王海波,王军,等.安徽省首起人感染H7N9禽流感家庭聚集病例的调查[J].中国热带医学,2017,17(2):151-155.
[7]曾志笠,朱蒙曼,袁辉,等.江西泰和县一起人感染H7N9禽流感家庭聚集性疫情调查[J].中华疾病控制杂志,2017,21(4):428-430.
[8]许桂峰,何展,黄耀云,等.茂名市2013-2014年活禽市场禽流感病毒污染状况监测[J].中国热带医学,2015,15(8):1020-1026.
[9]马岩,王吉玲,张冬艳,等.绍兴市11例人感染H7N9禽流感死亡病例流行特征分析[J].中国农村卫生事业管理,2017,37(12):1472-1474.
[10]曾健君,方巧云,刘燕,等.惠州市2013-2015年外环境禽流感病毒监测分析[J].中国热带医学,2016,16(7):692-694.
[11]颜玉炳,刘红莲,蒋丽娜,等.禽类外环境H7N9禽流感病毒检出率及其影响因素[J].中国热带医学,2016,16(1):49-51.
[12]周蕾,任瑞琦,张彦平,等.2014年9-12月中国内地人感染H7N9禽流感疫情流行病学特征分析[J].疾病监测,2015,30(4):265-268.
[13]郑向梅,王喜云,梅玉发,等.湖北省首例人感染H5N6禽流感病例流行病学调查[J].国际病毒学杂志,2017,24(2):85-89.
[14]琚雄飞,邹丽蓉,何伟锋,等.惠州市首例人H 7N9禽流感病例的实验室诊断和防控对策[J].中国热带医学,2015,15(2):163-166.
[15]陈帅,朱伟光,郭莹,等.2011-2015年宿迁市禽流感职业暴露人群和环境监测结果[J].现代预防医学,2016,43(12):2156-2159.
[16]周蕾,任瑞琦,张彦平,等.2014年9-12月中国内地人感染H7N9禽流感疫情流行病学特征分析[J].疾病监测,2015,30(4):265-268.
[2]高枫,阿不都热依木·阿布都克里木,樊旭成,等.乌鲁木齐市1例人感染H7N9禽流感确诊病例的调查处理[J].中国热带医学,2016,16(3):294-296
[3]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)[C].2014.01.29.
[4]王琦梅,刘社兰,陈恩富.人感染H7N9禽流感流行病学研究进展[J].中华预防医学杂志,2017,51(2):183-187.
[5]国家卫生和计划生育委员会.人感染H7N9禽流感诊疗方案[C].2017.01.001.
[6]胡晓申,王海波,王军,等.安徽省首起人感染H7N9禽流感家庭聚集病例的调查[J].中国热带医学,2017,17(2):151-155.
[7]曾志笠,朱蒙曼,袁辉,等.江西泰和县一起人感染H7N9禽流感家庭聚集性疫情调查[J].中华疾病控制杂志,2017,21(4):428-430.
[8]许桂峰,何展,黄耀云,等.茂名市2013-2014年活禽市场禽流感病毒污染状况监测[J].中国热带医学,2015,15(8):1020-1026.
[9]马岩,王吉玲,张冬艳,等.绍兴市11例人感染H7N9禽流感死亡病例流行特征分析[J].中国农村卫生事业管理,2017,37(12):1472-1474.
[10]曾健君,方巧云,刘燕,等.惠州市2013-2015年外环境禽流感病毒监测分析[J].中国热带医学,2016,16(7):692-694.
[11]颜玉炳,刘红莲,蒋丽娜,等.禽类外环境H7N9禽流感病毒检出率及其影响因素[J].中国热带医学,2016,16(1):49-51.
[12]周蕾,任瑞琦,张彦平,等.2014年9-12月中国内地人感染H7N9禽流感疫情流行病学特征分析[J].疾病监测,2015,30(4):265-268.
[13]郑向梅,王喜云,梅玉发,等.湖北省首例人感染H5N6禽流感病例流行病学调查[J].国际病毒学杂志,2017,24(2):85-89.
[14]琚雄飞,邹丽蓉,何伟锋,等.惠州市首例人H 7N9禽流感病例的实验室诊断和防控对策[J].中国热带医学,2015,15(2):163-166.
[15]陈帅,朱伟光,郭莹,等.2011-2015年宿迁市禽流感职业暴露人群和环境监测结果[J].现代预防医学,2016,43(12):2156-2159.
[16]周蕾,任瑞琦,张彦平,等.2014年9-12月中国内地人感染H7N9禽流感疫情流行病学特征分析[J].疾病监测,2015,30(4):265-268.