南昌市人感染禽流感死亡病例的发病特征与防控效果
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摘要
目的分析南昌市人感染H7N9/H10N8禽流感死亡病例的发病特点和感染来源,探讨防控对策。方法收集2013年4月-2018年3月南昌市人感染禽流感确诊死亡病例的流行病学个案调查资料、患者相关标本和活禽交易场所及活禽相关样本检测结果,进行描述性流行病学分析。结果南昌市2013年4月-2018年3月年报告人感染H7N9/H10N8禽流感死亡病例8例,男女比例5∶3;发病年龄中位数为72.5岁,并以有基础性疾病者为主;> 65岁7例;均在春节期间及春节前后发病。无病例在发病当天就诊,病例发病至确诊时间和服用磷酸奥司他韦(达菲)时间间隔长。7例有明确禽类暴露史;密切接触者观察期内流感病毒核酸检测均为阴性,病例可疑暴露环境相关标本中H7N9/H10N8禽流感病毒核酸检测阳性率为15.75%;落实各项防控措施后,暂无新发病例。结论南昌市人禽流感死亡病例特征明显,主要为大于65岁,合并基础疾病、诊疗不及时和禽类暴露。春节期间及春节前后,应加强民众禽流感宣教,切实加强推进关闭活禽交易市场等有效防控措施。
Objective To analyze the epidemiological characteristics of human infection with avian influenza A virus in Nanchang,and provide the basis for the prevention and control. Methods From April of 2013 to March of 2018, the epidemiological data of confirmed death cases of human infection with avian influenza were collected in Nanchang, and the results of patient-related specimens, live poultry trade sites and live poultry related samples were carried out. Descriptive analysis was used to analyze the epidemiological characteristics of cases and the problems of prevention and control. Results8 death cases were confirmed with H7 N9/H10 N8 virus infection from April 2013 to March 2018 in Nanchang. The male to female ratio of the cases was 5:3. The median age of the patients was 72.5 years(55 to 82), and 7 of these cases were over 65 years old. Most of them were elderly with chronic underlying diseases. The peak time of avian influenza outbreaks is during and around the Spring Festival, and there are no cluster cases. No case was visited on the day of onset. The time gap between onset and oseltamivir phosphate-taking was large. 7 cases had poultry exposure. All 76 close contacts were negative for avian influenza A virus. The positive rate of suspected exposure environment specimens was 15.75%. After the implementation of various prevention and control measures, there were no new cases. Conclusion The characteristics of death cases of avian influenza in Nanchang were obvious, mainly including over 65 years of age, with underlying diseases, lack of timely diagnosis and treatment and poultry exposure. During and around the Spring Festival, we should strengthen public awareness of avian flu, and effectively promote the closure of live poultry market and other prevention and control measures.
Objective To analyze the epidemiological characteristics of human infection with avian influenza A virus in Nanchang,and provide the basis for the prevention and control. Methods From April of 2013 to March of 2018, the epidemiological data of confirmed death cases of human infection with avian influenza were collected in Nanchang, and the results of patient-related specimens, live poultry trade sites and live poultry related samples were carried out. Descriptive analysis was used to analyze the epidemiological characteristics of cases and the problems of prevention and control. Results8 death cases were confirmed with H7 N9/H10 N8 virus infection from April 2013 to March 2018 in Nanchang. The male to female ratio of the cases was 5:3. The median age of the patients was 72.5 years(55 to 82), and 7 of these cases were over 65 years old. Most of them were elderly with chronic underlying diseases. The peak time of avian influenza outbreaks is during and around the Spring Festival, and there are no cluster cases. No case was visited on the day of onset. The time gap between onset and oseltamivir phosphate-taking was large. 7 cases had poultry exposure. All 76 close contacts were negative for avian influenza A virus. The positive rate of suspected exposure environment specimens was 15.75%. After the implementation of various prevention and control measures, there were no new cases. Conclusion The characteristics of death cases of avian influenza in Nanchang were obvious, mainly including over 65 years of age, with underlying diseases, lack of timely diagnosis and treatment and poultry exposure. During and around the Spring Festival, we should strengthen public awareness of avian flu, and effectively promote the closure of live poultry market and other prevention and control measures.
引文
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[12]贾永朝,罗兴,徐霞,等.2008-2017年广元市家禽职业暴露人群和外环境禽流感病毒监测分析[J].预防医学情报杂志,2018,34(6):780-786.
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[14]Chen LJ,Lin XD,Tian JH et al.Diversity,evolution and population dynamics of avian influenza viruses circulating in the live poultry markets in China[J].Virology,2017,505:33-41.?
[15]Wang X,Wang Q,Cheng W,et al.Risk factors for avian influenza virus contamination of live poultry markets in Zhejiang,China during the 2015-2016 human influenza season[J].Scientific Reports,2017,7:42722.
[16]刘晓青,曾志笠,傅伟杰,等.江西省2015-2016年活禽市场禽流感监测分析[J].中华疾病控制杂志,2018,22(2):161-164.
[17]谢文静,胡茂红,宋文涛,等.南昌市活禽市场禽流感病毒及从业人员特征分析[J].中华疾病控制杂志,2016,20(9):905-909.
[2]Bi YH,Zhang ZJ,Liu WJ,et al.Highly pathogenic avian influenza A(H5N1)virus struck migratory birds in China in 2015[J].Scientific Reports,2015,5:12986.
[3]Ni XS,He FL,Hu MH,et al.Investigation of avian influenza virus in poultry and wild birds due to novel avian-origin influenza A(H10N8)in Nanchang City,China[J].Microbes and Infection,2015,17(1):48-53.
[4]曾志笠,刘晓青,傅伟杰,等.江西省人感染禽流感病例流行病学特征分析[J].现代预防医学,2016,43(22):4038-4039,4062.
[5]Hartman L,Zhu Y,Edwards KM,et al.Underdiagnosis of influenza virus infection in hospitalized older adults[J].Journal of the American Geriatrics Society,2018,66(3):467-472.
[6]杨洛贤,程庆林,张琼,等.慢性基础疾病与人感染H7N9禽流感病死风险校正关联性的Meta分析[J].预防医学,2018,30(6):557-564,569.
[7]Jefferson T,Jones M,Doshi P,et al.Oseltamivir for influenza in adults and children:systematic review of clinical study reports and summary of regulatory comments[J].BMJ(Clinical research ed.),2014,348(15):g2545.
[8]Su S,Gu M,Liu D,et al.Epidemiology,evolution,and pathogenesis of H7N9 influenza viruses in five epidemic waves since 2013 in China[J].2017,25(9):713-728.
[9]Liu M,Li X,Yuan H,et al.Genetic diversity of avian influenza a(H10N8)virus in live poultry markets and its association with human infections in China[J].Scientific Reports,2015,5:7632.
[10]张烨,李晓丹,邹淑梅,等.2009~2013年我国活禽市场环境样本中禽流感病毒的检测[J].病毒学报,2015,31(6):615-619.
[11]郑红英,李美霞,陆剑云,等.广州市社区居民人禽流感健康教育效果评价[J].医学动物防制,2018,34(6):589-591.
[12]贾永朝,罗兴,徐霞,等.2008-2017年广元市家禽职业暴露人群和外环境禽流感病毒监测分析[J].预防医学情报杂志,2018,34(6):780-786.
[13]Lam TT,Pybus OG.Genomic surveillance of avian-origin influenza A viruses causing human disease[J].Genome Medicine,2018,10:50.
[14]Chen LJ,Lin XD,Tian JH et al.Diversity,evolution and population dynamics of avian influenza viruses circulating in the live poultry markets in China[J].Virology,2017,505:33-41.?
[15]Wang X,Wang Q,Cheng W,et al.Risk factors for avian influenza virus contamination of live poultry markets in Zhejiang,China during the 2015-2016 human influenza season[J].Scientific Reports,2017,7:42722.
[16]刘晓青,曾志笠,傅伟杰,等.江西省2015-2016年活禽市场禽流感监测分析[J].中华疾病控制杂志,2018,22(2):161-164.
[17]谢文静,胡茂红,宋文涛,等.南昌市活禽市场禽流感病毒及从业人员特征分析[J].中华疾病控制杂志,2016,20(9):905-909.
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