2003年广州市流行性感冒病原学及血清学监测分析

Influenza virologic and epidemiologic surveillance in Guangzhou, 2003

目的 分析、掌握广州市流感病原学变化特点及流行趋势。方法 病例标本来自广州市 3家哨点医院的流感样病例和局部暴发疫点现患病例的漱口液或咽拭子 ;普通人群血清标本于流感流行高峰前 (3月 )和高峰后 (9月 )在其中一家哨点医院按 0～、5～、15～、2 5～、6 0岁以上 5个年龄组分层随机抽取普通人群进行采集 ;职业暴露人群血清标本于 9月份在花都区、从化市、增城市抽取饲养、销售、屠宰家禽职业人员进行采集。病原学采用MDCK细胞进行病毒分离 ,血清学采用微量半加敏红细胞抑制试验检测各型流感抗体。结果 检测 192 5份流感样病例标本 ,分离出流感病毒 2 6 5株 ,其中H3N2亚型 2 5 6株 ,B型 9株 ,分别占总病毒株的 96 6 %和 3 4 % ,未分离出H1N1亚型毒株 ;4～ 7月份分离的H3N2亚型毒株共 2 2 8株 ,占全年的 86 0 % ,此期未分离出B型毒株。全年共报告流感样局部暴发疫情 91起 ,4～ 7月份流行高峰期报告 82起 ,占全年的 90 1% ,其中 5 6起 (占 6 8 3% )为H3N2亚型引起。 3、9月份分别采集普通人群血清标本 180和 15 0份 ,流感病毒各型抗体中H3N2亚型抗体阳性率最高 ,3月份为 85 6 % (15 4 / 180 ) ,9月份为 90 7% (136 / 15 0 ) ;H1N1亚型、B(维多利亚系 ) 和B(巴拿马系 ) 抗体阳性率偏低 ,仅为

Objective To understand the antigenic characteristics of influenza viruses and influenza activities in Guangzhou. Methods The specimen from influenza like illness (ILI), influenza cases and general population were collected from sentinel hospitals, occupational groups were collected from butchering, selling and raising poultry. Virus isolation by MDCK cell culture and antibodies test by semi-sensitivity haemagglutination inhibition. Results 265 influenza strains were isolated from 1 925 specimens of ILI cases and 96.6% (256) were identified as A type viruses (H3N2) and 3.4% (9) as B type. 228 strains of A (H3N2) were isolated in the period from April to July. In the year of 2003, 91 outbreaks were reported and 82 (90.1%) cases in April to July and 56 (68.3%) cases caused A type viruses (H3N2). In general population , the positive rate of antibody to A/H3N2 was the highest one with 85.6% in March and 90.7% in September, whereas the rates for A/H1N1,B/Victoria and B/yamagata were 8.9%-36.0%. In occupational groups, 1.9% (5/263) were A/H9N2 antibody positive and none A/H5N1 antibody positive. Conclusion Influenza A /H3N2 was the predominant circulating influenza virus type in 2003. It is important to pay more attention to the antigenic variation of influenza A /H3N2 and avian fluenza surveillance.