摘要
目的分析2016—2018年中国大陆人感染高致病性禽流感(HPAI)H7N9病毒疫情和死亡病例,为降低疾病严重性,减少疾病负担提供科学依据。方法利用现有人感染H7N9禽流感监测数据,运用描述性流行病学方法对人感染HPAI病毒疫情的时间、空间及人群等相关流行病学特征进行分析,并比较存活病例与死亡病例的流行病学和临床特征差异。结果中国大陆共8个省份发现人感染HPAI H7N9病毒病例32例,死亡13例,病死率为40.63%,与人感染低致病性禽流感(LPAI) H7N9病毒病例(37.98%)比较差异无统计学意义(χ2=0.090,P=0.763)。人感染HPAI H7N9病毒病例中位年龄为59岁,男女性别比为1.67∶1,职业以农民为主(81.25%)。HPAI H7N9死亡与存活病例间在人群特征、发病时间、地区分布、病程关键时间间隔、暴露史和基础性疾病患病情况等因素方面差异无统计学意义。而与存活病例比较,急性呼吸窘迫综合征、肾功能不全、心力衰竭和感染中毒性休克等并发症为病例死亡的可能影响因素。结论 2016—2018年中国大陆人感染HPAI H7N9病毒病例病死率水平较高,特定临床症状或并发症的出现可能预示预后不良,应进一步加强临床诊疗相关研究,总结临床经验,同时有针对性地开展医务人员培训,以降低疾病的严重性。
Objective To analyze the epidemic and death cases of human infection with highly pathogenic avian influenza(HPAI) A(H7N9) virus in the mainland of China from 2016 to 2018,and provide evidences for reducing the severity and disease burden of human infection with highly pathogenic avian influenza virus.Methods Based on the existing surveillance data of human infection with HPAI A(H7N9) virus in China,descriptive epidemiological analysis was conducted on the time,area and population distributions of cases infected with HPAI A(H7N9) virus in China,and the epidemiologic and clinical characteristics of survival cases and death cases were compared.Results Since December 2016,a total of 32 cases of human infection with HPAI A(H7N9) virus,including 13 deaths,had been reported from 8 provinces in China.The case fatality rate was 40.63%,the difference was not significant compared with the cases infected with low pathogenic avian influenza(LPAI) A(H7N9) virus(37.98%)(χ^2=0.090,P=0.763).The median age of the cases was 59 years,and the male to female ratio of the cases was 1.67∶1.Up to 81.25% of the cases were farmers.There were no significant differences in population,time and area distributions as well as key time interval in the course of disease,exposure history and underlying medical condition between the survival cases and the death cases.The results showed that acute respiratory distress syndrome,renal failure,cardiac failure and septic shock might be the risk factors resulting the deaths of the cases of HPAI A(H7N9) virus infection.Conclusion The case fatality rate of human infection with HAPI A(H7N9) virus in the mainland of China was relatively high during 2016–2018.The occurrence of specific clinical manifestations and complications might predict the severe outcomes.It is necessary to strengthen the research and training on clinical diagnosis and treatment of human infection with highly pathogenic avian influenza virus in order to alleviate the severity of the disease.
作者
李超
任瑞琦
黎丹
张彦平
倪大新
李群
詹思延
周蕾
Li Chao;Ren Ruiqi;Li Dan;Zhang Yanping;Ni Daxin;Li Qun;Zhan Siyan;Zhou Lei(Public Health School,Peking University,Beijing 100871,China;Chinese Center for Disease Control and Prevention, Beijing 102206,China)
出处
《疾病监测》
CAS
2018年第12期985-989,共5页
Disease Surveillance
基金
科技部应急专项(No.10600100000015001206)
WHO PIP合作项目
中美新发和再发传染病合作项目~~
关键词
人感染高致病性H7N9禽流感
死亡病例
Human infection with highly pathogenic avian influenza A (H7N9)virus
Death case