河南省某医院7例确诊人感染H7N9禽流感病例分析

Analysis of the epidemiological investigation characteristics of 7 cases of H7N9 avian influenza in a hospital of Henan Province

目的调查分析河南省某医院报告的7例H7N9禽流感患者的流行病学及临床特征,为本地区疫情防控提供科学依据。方法采用回顾性流行病学调查方法,对7例患者的基本特征、流行病学史及临床特征进行描述和分析。结果7例患者均为男性,以中老年人为主,于冬春季发病。7例患者均有发热、咳嗽、胸闷症状,患者A与患者C有咯血症状。7例患者均使用呼吸机,患者A使用ECMO辅助呼吸。6例患者有禽类接触史,1例患者暴露史不明。发病到就诊中位数时间为2 d,发病到住院中位数时间为7 d,发病到确诊中位数时间为12 d。2例患者死亡,病死率为28.57%。7例患者H7N9禽流感核酸检测均为阳性,共有密切接触者76人,H7N9禽流感核酸检测均为阴性,平均每例患者涉及密切接触者10.86人,未发现人传人。结论人感染H7N9禽流感传播仍以接触禽类为主,未发现人传人证据。

Absrtact:Objective To investigate the epidemiological characteristics of 7 cases of H7 N9 avian influenza reported by a hospital in Henan Province and to provide scientific proof for epidemic prevention and control in the region.Methods The basic characteristics,epidemiological history and clinical characteristics of 7 patients were described and analyzed by a retrospective epidemiological in-vestigation method.Results The 7 patients are male,mainly middle-aged and elderly,and became ill in winter and spring.All the 7 patients had symptoms of fever,cough and chest tightness,and patient A and C has symptom of haemoptysis.In addition,all the patients were given ventilator,and patient A was given ECMO.Six patients had a history of poultry exposure and one patient had an unknown history of exposure.The median time from onset to treatment was 2 days,and that from onset to hospitalization was 7 days,and from onset to diagnosis was 12 days.2 patients died,the fatality rate is 28.57%.All the patients tested positive for H7 N9 avian influenza nucleic acid.Additionally,there were 76 close contacts,but all of them tested negative.The average number of close contacts per patients was 10.86.But there is no human-to-human transmission has been found.Conclusion The spread of H7 N9 avian influenza is still mainly in contact with poultry,and no human-to-human evidence has been found.