深圳市一起聚集性流感爆发的流行病学调查

Epidemiological survey of a clustering outbreak of influenza in Shenzhen City

目的 分析深圳市一所监狱发生一起聚集性流感爆发的流行病学资料，并评价控制效果，为预防控制流感疫情爆发积累经验。方法 采用PCR方法检测流感病毒核酸、ELISA方法检测流感病毒抗体，按GB15994—1995诊断流感病例，采用SPSS10．0统计资料，X^2比较不同监区、不同类别人群罹患率差异显著性。结果2004年7月3～26日罗湖区看守所爆发流感疫情，累计370例，高峰在7月10、11日，呈单峰右偏态分布。男性罹患率为17．50％（364／2089），女性罹患率为1．88％（6／320）。咽拭子流感病毒核酸检出率42．67％，其中疫情高峰期为57．14％，稳定控制期为10．00％．11份标本的分型结果全部为H3亚型，病原体为H3N2，SARS冠状病毒核酸全部阴性。血清流感病毒IgM抗体检出率2，41％，双相血清IgG抗体滴度4倍或以上增长率91．67％，最高滴度达1：1280，最高增长倍数达64倍，血清SARS—IgM及IgG抗体均阴性。8名现症病人标本肠病毒全部阴性。结论2004年7月深圳市某看守所在押人员爆发流感疫情，病原体为甲3型流感病毒，排除H5NI、SARS冠状病毒和肠病毒混合感染，经隔离治疗现症病人、普服金刚烷胺、改善通风条件、每天消毒监区等综合措施能有效控制流感疫情。

Objective To anlayze the prevalenct features of influenza and control results for acumulating experence in control of outbreak of influenza in high risk population of Shenzhen City. Methods DNA of flu virus was determined by PCR and antibodies to influenza virus were detected by ELISA, The patients were diagnosed according to sdantart of GB15994- 1995, and data ananlysis by SPSSI0.0. Results 370 patients were infected with influenza virus in the period of 3 -26 of July in Luohu Detaining Station, and the peak period was 10- 11 of July, showed one apex distribution. Infection rate in the capture room was 21.38% higher than that of impounding room with infection rate 3.50%, and showed significant diffrence between two group（X^2 = 130, P = 0, n = 1 ）, and infection rate was 100% （39/39） in capturing section and 29.63% （8/27） in the impounding section（X^2 = 38.24, P = 0, n = 1）. The infection rate in the males was 17.50%（364/2 080） and that in the females was 1.88%（6/320） ,（X^2 = 51.92, P = 0,n = 1 ）, showing significant diference. Clinically symptoms of fever , headache, insobriety, tears, snuffle and cough were 100 %, 69. 19%, 54.32%, 58.11%, 32.70% and 19.46%, respectively. PCR positive rates were 42.67%, being 57.14% in peak period and 10.00% in stable period, and all the pathogen of 11 sample of flu were H3N2. The positive rate of IgM antibody was 2.41 %, IgG antibody titer of double sera was 4 times or with an increasing rate of 91.67%. The highest titer was 1 ： 1280 and with the highest increased times of 64. PCR did not show positve reaction with primers of H5N1 or SARS,and the patient sera did not reaction with SARS - IgM , IgG and antigen, enterovirus. Conclusion Epidemic outbreak of influenza occurred in Shenzhen Detaining Station in July of 2004, and the pathegen is H3N2, and there is no mixed infection of the pathogen with HSNI, SARSCOV and enterovirus. The epidemic outbreak of influenza can be controlled by taking integrated control measures including isolating patients, treatment with drugs, improving ventilation and sterilization.