甲型H1N1流感家庭内传播影响因素的病例对照研究

A case-control study of the transmission of pandemic influenza A（H1N1） virus in families

目的 探讨影响甲型H1N1流感家庭内传播的危险因素,为制定防控策略提供理论依据.方法按1：2的病例对照研究设计,通过＂疾病监测信息报告管理系统＂在北京市范围内选择符合条件的出现二代病例的家庭作为病例组,调查该家庭中的首发病例和二代病例;而未出现二代病例的家庭且与病例组中的病例相匹配的家庭作为对照组,调查确诊病例和与确诊病例接触频率最高的一位家庭成员.通过问卷调查,收集家庭成员的基本信息、发病及就诊情况和生活方式等.运用条件logistic回归方法分析家庭内感染甲型H1N1流感的危险因素.结果 单因素条件logistic回归分析结果显示,二代病例的文化程度、家庭人口数、家庭人均居住面积、首发病例就诊时间、最近1个月内是否出现流感样症状、是否与原发病例居住在同一房间、是否开窗通风、是否有勤洗手的习惯以及是否接种甲型H1N1流感疫苗等与感染甲型H1N1流感病毒有关.多因素条件logistic回归分析结果表明,二代病例的文化程度（OR=0.42）、是否与原发病例居住在同一房间（OR=3.29）、是否开窗通风（OR=0.28）、是否有勤洗手的习惯（OR=0.71）及是否接种甲型H1N1流感疫苗（OR=0.05）等因素与感染甲型H1N1流感病毒有关.结论 主动接种甲型H1N1流感疫苗、隔离传染源、定期开窗通风及注重个人卫生是控制甲型H1N1流感家庭内传播的重要手段.

Objective To explore the characteristics of transmission of pandemic influenza A/H1N1, and to analyze the possible factors of influencing transmission in families and to provide scientific evidence for formulating strategies of H1N1 prevention and control. Methods A 1∶ 2 matched case-control study was conducted. The case was defined as a household with 2 or more cases and the control was defined as that with 1 case. Face-to-face interview with questionnaire was used to collect information of work and family life of the study participants. Conditional logistic regression was used to analyze the data. ResultsUnivariate analysis showed that factors such as education level of the secondary case, the number of family members, per capita living space, flu-like symptom, insulation of case, ventilation, hand-washing, and influenza A/H1N1 vaccine immunization were all associated with infection of influenza A/H1N1. Results of multivariate logistic regression analysis showed that variables such as education level of secondary case （OR=0.42）, insulation of case（OR=3.29）, ventilation, （OR=0.28）, hand-washing（OR=0.71）, influenza A/H1N1 vaccine immunization （OR=0.05）were all correlated to infection of influenza A/H1N1. Conclusions Factors such as vaccine, insulation, ventilation, and hand-washing can help persons in protection from infection of influenza A/H1N1, suggesting the importance of good hygienic habit and immunization with influenza A/H1N1 vaccine.