郑州市10例人感染H7N9禽流感病例分析
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摘要
目的分析郑州市报告的人感染H7N9禽流感病例的临床与流行病学特征。方法收集2017年1～5月郑州市报告的10例人感染H7N9禽流感确诊病例的临床及流行病学资料,采用描述流行病学方法进行分析。结果 10例确诊病例中死亡3例,病死率为30%;病例呈散发,无聚集性疫情报告;病例大多以发热为首发症状,主要临床表现有发热、咳嗽、呼吸困难等,肺部影像学检查表现为一侧或双侧肺炎,4例病人有胸腔积液;就诊次数中位数3次(3～5次),发病到确诊日期间隔中位时间为8 d(6～19 d);均在冬春季节发病;发病年龄平均为52. 1岁,以中老年人为主,男女比例为9∶1,7例病例来自农村地区; 10例病例中8例在发病前2周内有禽类接触史; 295名密切接触者中5人出现低热、咳嗽症状,咽拭子检测结果显示H7N9禽流感病毒核酸均呈阴性。结论中老年男性是人感染H7N9禽流感的高危人群,暂未发现人传人的证据,冬春季是高发季节,活禽市场暴露或活禽接触是人感染H7N9禽流感发病的危险因素。
Objective To analyze the clinical and epidemiological characteristics of cases of human infection with avian influenza A( H7 N9) reported in Zhengzhou City. Methods The epidemiological and clinical data of 10 confirmed cases of human infection with avian influenza A( H7 N9) reported in Zhengzhou City from January to May 2017 were collected and analyzed by descriptive epidemiological methods. Results Ten cases of human infection with H7 N9 were confirmed,including 3 cases of death( fatality rate 30%). The cases were sporadic and no epidemiological association was observed among the cases. Fever was common initial symptom in the most of cases,and the main clinic manifestations included fever,cough,and difficult breathing. The chest imaging examination of patients showed unilateral or bilateral pneumonia,and 4 cases had pleural effusion. Mean median times for seeking doctor was 3( 3 ～ 5) times,and mean median time from morbidity to diagnosis was 8( 6 ～ 19) days. All the confirmed cases were reported in winter and spring. The mean age of patients was 52. 1 year-old,and most of them were the elder. The ratio of male to female was 9∶ 1. 7 confirmed cases came from the rural areas. 8 confirmed cases had been exposed to the live poultry markets before 2 weeks of the morbidity. 5 of the 295 close contacts to confirmed cases appeared low-fever and cough,but no positive result related to novel influenza A( H7 N9) virus nucleic acid was detected from each close contact's throat swabs. Conclusion Middle-aged and elderly men were the high risk people of human infection with avian influenza A( H7 N9). No evidence of human-to-human transmission has been found. Winter and spring were seasons of high incidence. The infection with avian influenza A( H7 N9) virus might be associated with the exposure to live poultry markets or live poultry contacts.
Objective To analyze the clinical and epidemiological characteristics of cases of human infection with avian influenza A( H7 N9) reported in Zhengzhou City. Methods The epidemiological and clinical data of 10 confirmed cases of human infection with avian influenza A( H7 N9) reported in Zhengzhou City from January to May 2017 were collected and analyzed by descriptive epidemiological methods. Results Ten cases of human infection with H7 N9 were confirmed,including 3 cases of death( fatality rate 30%). The cases were sporadic and no epidemiological association was observed among the cases. Fever was common initial symptom in the most of cases,and the main clinic manifestations included fever,cough,and difficult breathing. The chest imaging examination of patients showed unilateral or bilateral pneumonia,and 4 cases had pleural effusion. Mean median times for seeking doctor was 3( 3 ～ 5) times,and mean median time from morbidity to diagnosis was 8( 6 ～ 19) days. All the confirmed cases were reported in winter and spring. The mean age of patients was 52. 1 year-old,and most of them were the elder. The ratio of male to female was 9∶ 1. 7 confirmed cases came from the rural areas. 8 confirmed cases had been exposed to the live poultry markets before 2 weeks of the morbidity. 5 of the 295 close contacts to confirmed cases appeared low-fever and cough,but no positive result related to novel influenza A( H7 N9) virus nucleic acid was detected from each close contact's throat swabs. Conclusion Middle-aged and elderly men were the high risk people of human infection with avian influenza A( H7 N9). No evidence of human-to-human transmission has been found. Winter and spring were seasons of high incidence. The infection with avian influenza A( H7 N9) virus might be associated with the exposure to live poultry markets or live poultry contacts.
引文
[1]涂文校,任瑞琦,王霄晔,等. 2017年7月全国突发突发公共卫生事件及需关注的风险评估[J].疾病监测,2017,32(7):535-538.
[2]国家卫生和计划生育委员会.人感染H7N9禽流感诊疗方案[Z].2014-01-24.
[3]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.
[4]龙云铸,李丹,唐雨新,等.人感染H7N9禽流感26例临床特征与病毒基因分析研究[J].中国感染控制杂志,2015,14(7):464-467.
[5] GAO HN,LH Z,CAO B,et al. Clinical findings in 111 cases of influenza A(H7N9)virus infection[J]. N End J Med,2013,368(24):2277-2285.
[6]孙海燕,童海江,崔大伟,等.人感染H7N9禽流感病毒的研究进展[J].中华临床感染病杂志,2017,10(1):68-75.
[7] LI Q,ZHOU L,ZHOU M,et al. Epidemiology of human infections with avian influenza A(H7N9)virus in China[J]. N Eng J Med,2014,370(6):520-532.
[8]姜立民,高孟,罗永能. 128例人感染H7N9禽流感流行病学分析[J].国际流行病学传染病学杂志,2013,40(3):147-150.
[9]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.
[10]陈颖峰,董晓莲,陈剑杰.浙江省德清县5例人感染H7N9禽流感病例流行特征分析[J].疾病监测,2015,30(7):574-577.
[11]龙术国,张金艳,熊新平. 2014-2015年株洲市禽类职业暴露人群及外环境禽流感病毒监测分析[J].实用预防医学,2016,23(7):854-856.
[12]邹丽容,毛小晓,武婕,等. 2012-2015年广东省活禽市场外环境禽流感病毒污染状况研究[J].激光生物学报,2016,25(3):276-282.
[13]刘伟,马利君,颜丙新,等.济宁市2013-2014年活禽市场外环境禽流感监测分析[J].应用预防医学,2015,21(6):396-399.
[2]国家卫生和计划生育委员会.人感染H7N9禽流感诊疗方案[Z].2014-01-24.
[3]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.
[4]龙云铸,李丹,唐雨新,等.人感染H7N9禽流感26例临床特征与病毒基因分析研究[J].中国感染控制杂志,2015,14(7):464-467.
[5] GAO HN,LH Z,CAO B,et al. Clinical findings in 111 cases of influenza A(H7N9)virus infection[J]. N End J Med,2013,368(24):2277-2285.
[6]孙海燕,童海江,崔大伟,等.人感染H7N9禽流感病毒的研究进展[J].中华临床感染病杂志,2017,10(1):68-75.
[7] LI Q,ZHOU L,ZHOU M,et al. Epidemiology of human infections with avian influenza A(H7N9)virus in China[J]. N Eng J Med,2014,370(6):520-532.
[8]姜立民,高孟,罗永能. 128例人感染H7N9禽流感流行病学分析[J].国际流行病学传染病学杂志,2013,40(3):147-150.
[9]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.
[10]陈颖峰,董晓莲,陈剑杰.浙江省德清县5例人感染H7N9禽流感病例流行特征分析[J].疾病监测,2015,30(7):574-577.
[11]龙术国,张金艳,熊新平. 2014-2015年株洲市禽类职业暴露人群及外环境禽流感病毒监测分析[J].实用预防医学,2016,23(7):854-856.
[12]邹丽容,毛小晓,武婕,等. 2012-2015年广东省活禽市场外环境禽流感病毒污染状况研究[J].激光生物学报,2016,25(3):276-282.
[13]刘伟,马利君,颜丙新,等.济宁市2013-2014年活禽市场外环境禽流感监测分析[J].应用预防医学,2015,21(6):396-399.
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