湖北省荆州市2010-2012年实验室确诊流感住院率估计

Estimation of hospitalization rate of laboratory confirmed influenza cases in Jingzhou city, Hubei province, 2010-2012

目的 估算2010－2012年湖北省荆州市流感所致严重急性呼吸道感染（SARI）病例的住院率。方法 2010－2012年在湖北省荆州市4家医院的住院病例中开展SARI监测,在患者知情同意后纳入收集人口学、临床表现、治疗情况及转归等信息,并采集呼吸道标本进行流感病毒PCR核酸检测。结果 2010年4月至2012年9月共纳入19 679例SARI病例,为荆州市城区常住居民,其中18 412例（93.6%）采集了鼻咽拭子开展PCR检测,阳性率为13.3%。实验室确诊流感导致的SARI住院率在2010－2012年连续3年的流感季分别为102/10万、132/10万和244/10万。不同的型别/亚型的流感病毒所致的住院率在2010－2011流感季 A（H3N2）为48/10万,A（H1N1）pdm2009为30/10万,B型为24/10万;2011－2012流感季A（H3N2）为42/10万,B型为90/10万;2012年4－9月A（H3N2）为 90/10万,B型为1/10万。A型和B型流感病毒所致住院均主要发生在〈5岁年龄组,以0.5～岁组最高。结论 湖北省荆州市流感造成一定住院负担,不同型别/亚型流感在不同流感季会导致不同的住院率,应将〈5岁儿童作为流感疫苗接种的重点推荐人群。

Objective To estimate the hospitalization rate of severe acute respiratory infection（SARI） cases attributable to influenza in Jingzhou city,Hubei province from 2010 to 2012. Methods SARI surveillance was conducted at four hospitals in Jingzhou city,Hubei province from 2010 to 2012. Inpatients meeting the SARI case definition and with informed consent were enrolled to collect their demographic information,clinical features,treatment,and disease outcomes,with their respiratory tract specimens collected for PCR test of influenza virus. Results From April,2010 to September,2012,19 679 SARI cases enrolled were residents of Jingzhou,and nasopharyngeal swab was collected from 18 412（93.6%） cases of them to test influenza virus and 13.3% were positive for influenza. During the three consecutive 2010-2012 flu seasons,laboratory-confirmed influenza was associated with 102 per 100 000,132 per 100 000 and 244 per 100 000,respectively. As for the hospitalization rate attributable to specific type/subtype of influenza virus,48 per 100 000,30 per 100 000 and 24 per 100 000 were attributable to A（H3N2）,A（H1N1） pdm2009,and influenza B,respectively in 2010-2011 season; 42 per 100 000 [A（H3N2）] and 90 per 100 000 （influenza B） in 2011-2012 season; 90 per 100 000 [A（H3N2）] and one per 100 000 [influenza B] from April,2010 to September,2012. SARI hospitalization caused by influenza A or B occurred both mainly among children younger than five years old,with the peak in children aged 0.5 year old. Conclusion Influenza could cause a substantial number of hospitalizations and different viral type/subtype result in different hospitalizations over influenza seasons in Jingzhou city,Hubei province. Children less than five years old should be prioritized for influenza vaccination in China.