1起人感染H7N9禽流感家庭聚集性疫情的流行病学调查
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摘要
目的针对吉安市发生的首起人感染H7N9禽流感家庭聚集性疫情开展流行病学调查,探索可能的感染来源,为人感染禽流感病毒疫情的防控提供科学依据。方法采用描述性流行病学方法对2名病例及其密切接触者开展流行病学调查,并采集其相关呼吸道标本,采用RT PCR方法开展H7N9病毒核酸检测。结果首例患者于2016年4月1日发病,17日确诊,被感染的途径为活禽市场暴露和与禽类接触;其母亲4月5日发病,17日确诊,被感染的可能途径有2种:(1)禽肉处理;(2)母亲与首例病例的密切接触。经过对患者的积极处置和救治,2名患者已出院,此次疫情得到有效的控制。结论此次疫情所涉及的2例病例确认为人感染H7N9禽流感家庭聚集性病例,首发病例通过禽类暴露而感染,续发病例因共同暴露感染可能性大,但无法完全排除有限人传人的可能性。
Objective Epidemiological investigation was conducted to carry out the first family clustering of human infection with avian influenza A(H7 N9) virus in Ji'an, and to explore the possible source of infection, in order to provide a scientific basis for further understanding and prevention of human infection with avian influenza virus. Methods Field epidemiological investigation was conducted for two patients and close contacts. The samples collected from the patients, environments and poultry were tested by using real time reverse transcriptase-polymerase chain reaction(RT-PCR). Results The first patient developed the symptom on April 1, 2016, and was diagnosed on the 17 th as case of human infection with avian influenza A(H7 N9) virus; the route of infection was exposure to live poultry markets and poultry contact. His mother developed the symptom on April 5 and was diagnosed on the 17 th as case of human infection with avian influenza A(H7 N9) virus; the route of infection may be poultry treatment or close contact with the first case. Conclusion This is a family clustering of human infection with H7 N9. The infection of the index case probably resulted from recent exposure to live poultry. For his mother(secondary case), the probable infection source was from the index case during the unprotected exposure, but the possibility from the live poultry or other source could not be ruled out.
Objective Epidemiological investigation was conducted to carry out the first family clustering of human infection with avian influenza A(H7 N9) virus in Ji'an, and to explore the possible source of infection, in order to provide a scientific basis for further understanding and prevention of human infection with avian influenza virus. Methods Field epidemiological investigation was conducted for two patients and close contacts. The samples collected from the patients, environments and poultry were tested by using real time reverse transcriptase-polymerase chain reaction(RT-PCR). Results The first patient developed the symptom on April 1, 2016, and was diagnosed on the 17 th as case of human infection with avian influenza A(H7 N9) virus; the route of infection was exposure to live poultry markets and poultry contact. His mother developed the symptom on April 5 and was diagnosed on the 17 th as case of human infection with avian influenza A(H7 N9) virus; the route of infection may be poultry treatment or close contact with the first case. Conclusion This is a family clustering of human infection with H7 N9. The infection of the index case probably resulted from recent exposure to live poultry. For his mother(secondary case), the probable infection source was from the index case during the unprotected exposure, but the possibility from the live poultry or other source could not be ruled out.
引文
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[9]刘延,霍细香,刘琳琳,等.人感染H5N1禽流感的流行与防治[J].公共卫生与预防医学,2014,25(4):66-69.
[2]刘晓青,傅伟杰,谢昀,等.江西省人感染H7N9禽流感流行病学特征分析[J].中华疾病控制杂志,2015,19(3):265-268.
[3]中华人民共和国国家卫生和计划生育委员会.人感染H7N9禽流感疫情防控方案(第三版)[EB/OL].[2018-12-29].http://www.nhfpc.gov.cn/jkj/s3577/201401/8c1828375a7949cd85454a76bb84f23a.shtml.
[4] Cheng QL, Ding H, Sun Z, et al. Retrospective study of risk factorsfor mortality in human avian influenza A(H7N9)cases in ZhejiangProvince, China, March 2013 to June 2014[J]. International Journalof Infectious Diseases, 2015, 39:95-101.
[5] Zhang ZF, Fan XH, Li KS, et al. Prevalence of avian influenza virusreceptor in human respiratory tract[J]. Progress in Biochemistry andBiophysics, 2008, 35(12):1387-1393.
[6] Virlogeux V, Li M, Tsang TK, et al. Estimating the distribution of theincubation periods of human avian influenza a(H7N9)virus infec-tions[J]. American Journal of Epidemiology, 2015, 182(8):723-729.
[7] Qi X, Qian YH, Bao CJ, et al. Probable person to person transmissionof novel avian influenza A(H7N9)virus in Eastern China, 2013:epidemiological investigation[J]. BMJ(Clinical research ed.), 2013,347:f4752.
[8]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(2014年版)[EB/OL].[2018-12-29].http://www.nhfpc.gov.cn/yzygj/s3593g/201401/3f69fe196ecb4cfc8a2d6d96182f8b22.shtml.
[9]刘延,霍细香,刘琳琳,等.人感染H5N1禽流感的流行与防治[J].公共卫生与预防医学,2014,25(4):66-69.