人感染H7N9禽流感流行特征与防控策略

Epidemiological characteristics and control strategies of avian influenza A(H7N9)

2013年3月31日中国大陆出现新型禽流感疫情,此次的H7N9禽流感病毒为全球首次发现的新亚型流感病毒,可能由3种流感病毒重组后产生。截至5月31日,我国内地共报告确诊病例131例,死亡39例。而在上海市报告的33例确诊病例中,29例发病于4月6日上海市关闭活禽交易市场前,其余4例发病于关闭后的第一个潜伏期内。33例病例中60岁以上患者占66.7%(22/33);15例死亡病例中,60岁以上患者占80%(12/15);90.91%(30/33)的病例具有可疑的动物或环境暴露史。此次疫情呈散发,虽然出现了2起家庭聚集性病例,但目前还没有明确的人传人的证据。疫情发生后,上海市人民政府适时启动了流感流行应急预案Ⅲ级响应,通过突发公共卫生事件应急响应、关闭全市活禽交易、健康教育、风险沟通等手段,及时有效地控制了疾病的传播。本文分析这次疫情防控工作的得失并提出建议,供今后的防疫工作借鉴参考。

A novel avian influenza was discovered in China's Mainland in March 2013, and the virus was identified as avian influenza A （H7N9）-a new virus that has not been reported previously before. Further research showed that the virus was probably a combination of three different subtypes of influenza A virus. By May 31, a total of 131 confirmed cases have been reported in China, including 39 deaths. Shanghai reported 33 confirmed cases, with the onset of 29 cases found before closing the live poultry markets by the municipal government on April 6. The onsets of the rest 4 cases were all found during the first incubation period after the closure. We found that 66.7% （22/33） of the confirmed cases in Shanghai were above 60 years of age, and of the 15 deaths, 80~ （12/15） were aged above 60 years old. It was also noted that 90.9% （30/33） of the confirmed cases had an exposure history to susceptible animals or environmental circumstances. The cases appeared to be sporadic; although there were two family clusters, no evidence of human-to-human transmission has been found so far. Shanghai municipal government activated the Flu Pandemic Preparedness and Response Plan （Level Ⅲ ） on April 2, 2013, timely after the first few cases was identified. The rapid responses of public health emergencies included citywide suspending of live poultry markets, health education, and risk communication; the epidemic was controlled effectively and timely. In this paper we analyzed the pros and cons of our prevention and control strategies, hoping to provide reference for future epidemics.