上海市黄浦区首例人感染H7N9禽流感病例现场流行病学分析

Field epidemiological analysis on the first case of human infection with avian influenza A (H7N9) in Huangpu District of Shanghai

目的结合人感染H7N9禽流感病例的调查处理探索突发公共卫生事件现场流行病学的应用效果。方法对1例人感染H7N9禽流感病例开展流行病学调查和密切接触者观察,采用RT-PCR法对核酸进行亚型的鉴定。结果根据临床表现和病原学检测结果,确诊为人感染H7N9禽流感病例;患者病前曾到过居住地附近的一家兼营活禽的菜市场买菜,吃过1次冻鸡肉,余无可疑接触史;对患者的4名密切接触者进行观察,未发现人与人之间的传播。病例呈现起病急、进展快和多脏器严重损害等特征,经积极救治无效,患者发病第7天死亡。疫情处理以疾病预防控制和临床专业为技术支撑,政府重视,多部门协作;报告及时,反应迅速;多次流调,不断充实完善;收到良好的效果。结论病毒株为禽类性特征,未见人间传播,但病毒感染来源和传播因素不明;现场流行病学为突发公共卫生事件应对提供了重要的理论和方法。

[ Objective] Based on the investigation and treatment of the cases of human infection with avian influenza A （ H7N9 ）, to study the application effect of field epidemiology on public health emergencies. [ Methods ] The epidemiological investigation and observation of close contacts were performed on a case of human infection with avian influenza A （ H7N9 }, and the subtype of viral nucleic acid was identified by RT-PCR. [ Results]The case was confirmed as the human infection with avian influenza A （H7N9） according to the chnical manifestations and pathogen detection. Before onset of the disease, the patient had done some shopping in a live poultry market near his house, and has eaten the frozen chicken once, while there was no other suspicious contact history. 4 close contacts of the patient were observed, and interpersonal transmission was not found. The disease had the characteristics of a- cute onset, rapid progress and serious damage to multiple organs. Although with active rescue, the patient died on the seventh day of onset. In the epidemic treatment, disease control and prevention institutions, and clinical professionals provided the technical support, the government paid great attention to, and the multi-sector collaboration was performed. The reports of disease were time-ly, and the response was rapid. The epidemiological investigation was conducted frequently, to constantly enrich and perfect the survey data, and the effect was satisfactory. [ Conclusion] The virus strain has poultry characteristics, and there is no interpersonal transmission. However, the virus infection sources and transmission factors are not known. The field epidemiology provides an im-portant theory and method for public health emergency response.