部队呼吸道腺病毒疫情流行病学调查分析

Epidemiological investigations of outbreaks of human adenovirus associated respiratory diseases in military units

目的分析我国部队呼吸道腺病毒暴发疫情的流行特点、暴发原因及临床表现,为有效控制疾病的发生与蔓延提供依据。方法从PubMed、万方数据库搜集2009-2017年国内公开报道的部队呼吸道腺病毒暴发疫情文献,对疫情暴发的流行病学特征和临床表现进行统计分析。结果病原分型:7型、55型暴发病例最多,分别占暴发疫情的47.11%(1782/3783)和30.11%(1139/3783)。7型10起,检测数551例,阳性率为54.02%(551/1020);55型5起,检测数1035例,阳性率为90.10%(437/485);时间分布以2013年最多,共发生7起;发病时间主要集中在每年12月至次年3月;河南地区报告最多,共发生4起;主要以新兵为高发人群,共18起是新兵为主的聚集性暴发疫情。呼吸道腺病毒临床表现主要为发热(50.83%~100.00%)、咽部充血(37.91%~100.00%)、咳嗽(48.17%~95.45%)、咽痛(57.14%~87.00%)、咳痰(15.66~85.23%)等症状。结论呼吸道腺病毒是引起部队暴发疫情的主要病原体之一,提示应加强疫情监测和防控工作,防止疫情的扩大蔓延。

Objective To analyze the epidemiology of outbreaks and clinical characteristics of respiratory diseases caused by human adenovirus(HAdV)in military units so as to provide data for disease prevention and control.Methods Data on respiratory adenovirus outbreaks between 2009 and 2017 was collected from PubMed and Wanfang Database.The epidemiologic and clinical data and the serotypes of adenovirus were also analyzed.Results The dominating serotypes of adenovirus were 7 and 55,which accounted for 47.11%(1782/3783)and 30.11%(1139/3783)of the total cases of outbreaks,respectively.There were 10 outbreaks related to serotype 7,and 54.02%of the 1020 cases were positive.There were 5 outbreaks related to serotype 55,and 90.10%of the cases(437/485)were positive.The peak time was in 2013,with four outbreaks.Seasonal outbreaks mostly occurred in spring and winter,or to be more specific,between December and March.In terms of regional distribution,Henan Province had the largest number of outbreaks.The high-risk populations were new recruits,among whom the number of outbreaks was 18.The clinical features of adenovirus infection were fever(50.83%-100.00%),pharyngeal hyperemia(37.91%-100.00%),cough(48.17%-95.45%),sore throat(57.14%-87.00%)and expectoration(15.66%-85.23%).Conclusions HAdV has become one of the main pathogenic microorganisms,which induces acute respiratory diseases in the military in China.It is necessary to reinforce epidemic surveillance to curb the spread of the disease.