中国流行性感冒流行病学及疾病负担浅析

Epidemiology and disease burden analysis of influenza in China

目的分析汇总近年发表或公开的中国流行性感冒(流感)流行病学数据,浅析流感在中国造成的疾病及经济负担,为完善中国流感防控策略提供科学依据。方法在PubMed、万方数据及中国知网等数据库搜索中国近年发表的流感流行病学相关文章,并在中华人民共和国国家卫生和计划生育委员会(国家卫生计生委,原卫生部)和世界卫生组织(world health organization,WHO)网站分别搜索流感法定报告和监测数据。对数据进行汇总和描述性分析。结果 2005-2010年国家卫生计生委发布的全国流感报告发病数分别是45 672、57 557、36 434、41 692、198 381和64 502例,死亡数分别是5、4、2、3、13和7例。流行病学调查广东省珠海、肇庆2地合计2006年和2007年估测年发病率分别为4 780/10万和751/10万,广州市2006年估测年发病率为2 382/10万,珠海市2008年和2009年年估测发病率为410/10万和1 920/10万,流行病学调查获得的流感发病率显著高于法定报告数据。流感大流行对人群的影响非常显著,大幅增加流感导致的医疗负担,2006年珠海和肇庆两市流感样疾病发病达246万人次,其经济负担达5亿元,推测广东省2007年流感样疾病造成的直接医疗经济负担估计为10亿元。另外,中国近年流感监测结果显示B型流感两种细胞系在人群中共流行。结论需要进一步开展流感疾病及经济负担相关调查,以正确评估流感流行造成的危害,加强对B型流感的监测与防控。

Objective To summarize the epidemiological data of influenza in China published or available for re cent years and analyze the economic burden. Methods Published epidemiological data of influenza were collect- ed from PubMed, Wanfang Database of China and China National Knowledge Infrastructure database （CNKI）. National notification data and surveillance data of China for influenza were obtained from the National Health and Family Planning Commission of China （NHFPC, ex-MOH） and the World Health Organization （WHO）, respectively. Basic statistic tools were used for the data analysis. Results From 2005 to 2010, the numbers ofNHFPCreportedinfluenzacaseswere45 672, 57 557, 36434, 41 692, 198 381and64 502, re- spectively; the death cases were 5, 4, 2, 3, 13 and 7, respectively. The incidence rates of influenza demon- strated by passive surveillance were 4 780/100 000 in 2006 （Zhuhai city） and 751/100 000 in 2007 （Zhaoqing city）, 2 382/100 000 in Guangzhou city in 2006, 410/100 000 in 2008 and 1 920/100 000 in 2009 in Zhuhai city of China. The incidence rates observed in the epidemiological studies were significantly higher than that from the passive surveillance. Pandemics of influenza had a great impact on the population and account for a significant increase in the burden on health care system. For example, the incidence of influenza-like illness reached 2 460 000 in Zhuhai city and Zhaoqing city of China, which caused the economic burden at about 500 millions of Chinese yuan （about 80 millions of US dollars） . Based on these data, the estimated cost of influ- enza-like illness in Guangdong province was about 160 US dollars. In addition, co-circulation of two lineages of influenza B strain was observed in the surveillance data. Conclusions Influenza is a costly burden in Chi na. Surveillance and measures of control and prevention for type 13 influenza should be enhanced.