辽宁省2016-2017年人感染H7N9禽流感病例流行病学研究
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摘要
目的分析辽宁省2016-2017年人感染H7N9禽流感疫情情况,为制定防控策略提供科学依据。方法对"人感染H7N9禽流感信息系统"辽宁省2016-2017年本地报告的5例人感染H7N9禽流感确诊病例为研究对象,对流行病学资料、外环境监测数据进行描述性流行病学分析。结果截止2018年6月,辽宁省共确诊人感染H7N9禽流感5例,2016年1例,2017年4例,其中死亡病例4例,男女比例为4∶1,发病年龄中位数62岁;>50岁4例;农民打工者2例,退休职工2例;均为散发病例,分布于3个地市的5个县区;从发病后到首次就诊、确诊及使用奥司他韦进行抗病毒治疗的时间中位数分别为3 (3～4)d、11(9～12) d和8(7～10) d;均有禽类相关暴露史;400名密切接触者中在1周的医学观察期内,除8例出现流感样症状(H7N9检测结果为阴性)外,其他人员均正常;连续2年外环境加强监测禽流感病毒核酸检测阳性率分别为3.24%和8.70%。结论辽宁省人感染H7N9禽流感病例的基本人口学特点和主要感染途径均未发生明显变化。需加强禽类管理,防止疫情的发生与扩散。
Objective To understand the epidemiological characteristics of human infection with avian influenza A(H7N9) virus in Liaoning province in 2016-2017, and to provide evidence for disease prevention and control. Methods Five confirmed cases of human infection with H7N9 avian influenza virus in Liaoning province from 2016 to 2017 were enrolled, and a descriptive epidemiological analysis was conducted on epidemiological data and external environmental monitoring data. Results Among the five confirmed cases,4 patients died, the male to female ratio was 4∶1.The median age of patients was 62 years old, 4 patients were over 50 years old.2 cases were farmers and 2 cases were retired workers.5 cases sporadically appeared in 5 counties.The median times from disease onset to first visit, diagnosis and to treatment with oseltamivir were 3(3-4) days, 11(9-12) days and 8(7-10) days, respectively; All cases had history of exposure to live poultry or contaminated environments.Out of 400 close contacts, eight developed flu-like symptoms(H7N9 negative) during one week observation.The positive rates of avian influenza viruses by PCR were 3.24% and 8.70% in the consecutive 2 year environmental monitoring period. Conclusions There is no significant change in the basic demographic characteristics and major infection routes of avain influenza A(H7N9) virus in Liaoning province.Management of poultry needs to be strengthened for the prevention of potential environment contamination of avain influenza A(H7N9) virus.
Objective To understand the epidemiological characteristics of human infection with avian influenza A(H7N9) virus in Liaoning province in 2016-2017, and to provide evidence for disease prevention and control. Methods Five confirmed cases of human infection with H7N9 avian influenza virus in Liaoning province from 2016 to 2017 were enrolled, and a descriptive epidemiological analysis was conducted on epidemiological data and external environmental monitoring data. Results Among the five confirmed cases,4 patients died, the male to female ratio was 4∶1.The median age of patients was 62 years old, 4 patients were over 50 years old.2 cases were farmers and 2 cases were retired workers.5 cases sporadically appeared in 5 counties.The median times from disease onset to first visit, diagnosis and to treatment with oseltamivir were 3(3-4) days, 11(9-12) days and 8(7-10) days, respectively; All cases had history of exposure to live poultry or contaminated environments.Out of 400 close contacts, eight developed flu-like symptoms(H7N9 negative) during one week observation.The positive rates of avian influenza viruses by PCR were 3.24% and 8.70% in the consecutive 2 year environmental monitoring period. Conclusions There is no significant change in the basic demographic characteristics and major infection routes of avain influenza A(H7N9) virus in Liaoning province.Management of poultry needs to be strengthened for the prevention of potential environment contamination of avain influenza A(H7N9) virus.
引文
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[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分析[J].现代预防医学,2016,43(12):2156-2159.
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[17] 郜振国,刘万里,赵俊,等.2016年新疆地区外环境禽流感监测及职业暴露人群血清学调查[J].职业与健康,2018,34(8):1034-1037.
[18] 陈诹,徐红梅,王远萍,等.2014-2017 年上海市浦东新区外环境H7N9 禽流感病毒监测分析[J].公共卫生与预防医学,2018,29(3):45-48.
[19] 傅伟杰,刘晓青,袁辉,等.江西省2012-2015年禽类外环境中禽流感监测及感染病例分析[J].中华疾病控制杂志,2017,21(6):590-593.
[20] 刘美,刘晓青,傅伟杰,等.2015-2016 年江西省外环境禽流感病毒监测分析[J].现代预防医学,2017,44(23):4373-4376,4401.
[21] 范苏云,石向辉,周洁,等.2014-2016年深圳市福田区外环境H7N9禽流感病毒及职业人群监测[J].热带医学杂志,2018,18(1):82-85.
[22] 陈纯,陆剑云,李魁彪,等.气象因素对活禽市场外环境H7N9禽流感病毒影响作用分析[J].首都公共卫生,2017,11(2):56-58.
[2] 国家卫生计生委办公厅.人感染H7N9禽流感疫情防控方案(第3版)[J].全科医学临床与教育,2014,12(2):123-125.
[3] 曹明华,侯赛,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.
[4] 罗美玲,胡世雄,邓志红,等.湖南省人感染H7N9禽流感患者流行病学调查研究[J].中国预防医学杂志,2017,18(12):923-928.
[5] 陈恩富,柴程良,孙继民,等.浙江省人感染H7N9禽流感流行特征与防控对策[J].中国公共卫生,2013,29(5):625-627.
[6] 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.
[7] 庞志峰,朱军礼,唐慧玲,等.浙江省金华市2014-2016年人感染H7N9禽流感流行特征分析[J].中国媒介生物学及控制杂志,2018,29(4):369-372.
[8] 许可,霍翔,黄昊頔,等.2013-2016年江苏省人感染H7N9禽流感流行特征及影响因素分析[J].江苏预防医学,2017,28(3):241-244.
[9] 于霄云,连志勇,王萍,等.辽宁省首例人感染H7N9禽流感病例流行病学调查[J].中国公共卫生,2018,34(3):442-444.
[10] Yu H,Wu JT,Cowling BJ,et al.Effect of closure of live poultry markets on poultry-to-person transmission of avian influenza A H7N9 virus:an ecological study[J].Lancet,2014,383(9916):541-548.
[11] 焦玲艳,王相超,王颖,等.天津市首例人感染H7N9禽流感病例流行病学调查[J].现代预防医学,2017,44(20):3794-3797.
[12] 刘静雯,刘慧,陆剑云,等.广州市2013-2015年人感染H7N9禽流感外环境监测结果分析[J].中国公共卫生,2016,32(10):1382-1386.
[13] 何为涛,谭毅,闭福银,等.2010～2011年广西活禽市场外环境禽流感病毒污染调查[J].应用预防医学,2013,19(1):6-8.
[14] 王喜云,梅玉发,刘经凤,等.十堰市2012年不同场所禽流感H5与H9检测结果分析[J].中国公共卫生,2014,30(1):30-32.
[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分析[J].现代预防医学,2016,43(12):2156-2159.
[16] 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.
[17] 郜振国,刘万里,赵俊,等.2016年新疆地区外环境禽流感监测及职业暴露人群血清学调查[J].职业与健康,2018,34(8):1034-1037.
[18] 陈诹,徐红梅,王远萍,等.2014-2017 年上海市浦东新区外环境H7N9 禽流感病毒监测分析[J].公共卫生与预防医学,2018,29(3):45-48.
[19] 傅伟杰,刘晓青,袁辉,等.江西省2012-2015年禽类外环境中禽流感监测及感染病例分析[J].中华疾病控制杂志,2017,21(6):590-593.
[20] 刘美,刘晓青,傅伟杰,等.2015-2016 年江西省外环境禽流感病毒监测分析[J].现代预防医学,2017,44(23):4373-4376,4401.
[21] 范苏云,石向辉,周洁,等.2014-2016年深圳市福田区外环境H7N9禽流感病毒及职业人群监测[J].热带医学杂志,2018,18(1):82-85.
[22] 陈纯,陆剑云,李魁彪,等.气象因素对活禽市场外环境H7N9禽流感病毒影响作用分析[J].首都公共卫生,2017,11(2):56-58.