开封市首例人感染H7N9禽流感调查报告

Survey of initial case of human infection with avian influenza A(H7N9) virus in Kaifeng City

目的确定人感染H7N9禽流感疫情,查明感染来源,以便采取相应措施控制疫情,为今后预防控制工作提供科学依据。方法对河南省开封市1例不明原因肺炎病例进行现场流行病学调查,同时采集患者咽拭子,采用荧光定量PCR方法进行流感病毒核酸检测,包括甲型、H1亚型、H3亚型、H5亚型、H7亚型和N9亚型。根据现场流行病学调查和实验室检测结果对该病例进行诊断和分析。结果该患者厨师职业,病初表现为流感样症状,并伴有胸闷,病情持续性加重,临床诊断为重症肺炎、急性呼吸窘迫综合征,不排除人感染H7N9禽流感病毒的可能。患者咽拭标本禽流感病毒(H7N9)核酸阳性。患者发病前未接触过类似病人,但接触过屠宰的禽类。所有密切接触者经医学观察8 d均未出现类似症状。结论该病例确诊为开封市首例人感染H7N9禽流感病例,未发现人传人的现象。

Objective To confirm a human case of infected with avian influenza A（H7N9） virus and indentify infectioussource,so as to control the spread of infection with H7N9 virus in human and provide a scientific basis for future preventionand control. Methods Field and loboratory survey of an unexplained pneumonia case were made. Throat swab samples ofwere collected from patients and tested by real-time RT-PCR（including A type, H1 subtypes, H3 subtypes, H5 subtypes, H7subtypes, N9 subtypes）. Results Influenza- like symptoms along with chest tightness in a male chef patient initiallydemonstrated and aggravated continuously. The case was clinically diagnosed as serious pneumonia and ARDS, but possibilityof H7N9 avian influenza existed. The throat swab specimens were tested positive for H7N9. The patient didn＇t contacted withsimilar patients but with slaughtered poultry. All contacts were under daily surveillance for 8 days and no similar symptomswere observed. Conclusion The human case infected with avian influenza A（H7N9） virus in 2013 was the initial onediagnosed and reported in Kaifeng City. And there was no evidence of person-to-person transmission.