摘要
目的了解福建省H7N9禽流感病例的特征,为进一步防控提供参考。方法从人感染H7N9禽流感信息管理系统收集福建省2013~2014年人感染H7N9禽流感疫情资料,用描述性流行病学方法分析其流行特征。2014年福建省活禽市场的外环境标本数据来源于应急监测资料。资料统计分析使用Epi info软件。结果 2013、2014年福建省共确诊22例实验室确诊人感染H7N9病例,其中死亡6例,病死率27.27%。86.36%（19/22）的病例为男性,死亡6例,病死率31.58%,13.64%（3/22）的病例为女性,无女性死亡病例。发病时间主要集中在2013年的4月和2014年的1月,2013、2014年病死率分别为20.00%、29.41%。77.78%（7/9）的设区市、15.91%（14/88）的县（市、区）报告病例,主要集中泉州、福州和厦门（占总数的82%）,未发现聚集性疫情和二代病例。病例的年龄为3~81岁,中位年龄52岁,下四分位数P25~上四分位数P75：30~60岁,死亡病例的年龄为27~81岁,中位年龄55岁,P25~P75范围：30~81岁。54.55%（12/22）的病例有去过活禽市场。77.78%（21/27）县（市、区）、38.61%（39/101）活禽市场、25.36%（157/619）标本应急监测禽流感阳性。68.18%（15/22）的病例有基础性疾病。13.64%（3/22）的病例通过ILI监测发现,均为轻症病例。86.36%（19/22）通过不明原因肺炎监测发现,均为重症病例。病例390名密切接触者中在医学观察期限内出现发热等症状有15人,检测咽拭子H7N9均为阴性。结论福建省人感染H7N9禽流感病例以散发为主,未出现聚集性疫情和二代病例,冬春高发。男性病死率高于女性,年龄大的病例构成比大。病例的主要暴露史是去过活禽市场,活禽市场外环境污染严重。通过ILI监测发现的病例均为轻症病例,通过不明原因肺炎监测发现的病例均为重症病例。在发生人感染H7N9禽流感确诊病例的县（区）内,应当在病例确诊后开展为期2周的强化监测。
Objective To understand the epidemiological characteristics of avian influenza A（H7N9） in Fuiian province during 2013-2014,so as to provide reference for HTN9 prevention and control. Methods Data on human infection of HTN9 were collected in Fujian province from information management system during 2013-2014 people,using descriptive epidemiological methods to analyze the epidemio!ogical features. In 2014, specimens of the external environment of live poultry market data in Fuiian province from the emergency monitoring data. Epi info software was used for statistical anal- ysis of the data. Results A total of 22 laboratory confirmed cases were reported in Fujian province during 2013-2014, including 6 death cases,the fatality rate was 27.27%. Males accounted for 86.36% （19/22） and the fatality rate was 31.58 %. Females accounted for13.64 % （3/22） and the fatality rate was 0 %. The peak period of reported infection cases was in April, 2013 and January, 2014. The fatality rate was 20.00% and 29.41% in 2013 and 2014 respectively. Cases were found in 7 cities with districts out of 9 in Fujian province,and were mainly located in Quanzhou,Fuzhou and Xiamen cities（81.82% out of the total）. 15.91% counties （14 out of 88） in Fujian province reported cases. There was no cluster of cases. The median age was 52 years（range 3 to 81） and death cases median age was 55years（range 27to 81）. 54.55 （12/22） cases before the onset of exposure to the live poultry markets. Environmental samples outside the emergency monitoting results showed that 77.78 % （21/27） counties,38.61% （39/101） live bird markets,25.36% （157/619） sample positive for avian influenza. 68.18% （15/22） of the cases had underlying diseases. 13.64% of cases discovered by ILI surveillance were mild cases. 86.36 % of cases discovered by pneumonia surveillance were severe cases. In 390 close contacts of cases having fever and other symptoms,15 people whose swabs were negative for H7Ng. Conclusion Cases of avian influenza A（H7Ng） in Fujian province are sporadic, without cluster and secondary cases. The peak period of onset of symptoms is winter and spring. The fatality rate is higher in males than that in females. Cases are mainly older people and major exposures have been to live poultry markets, which are seriously contaminated by avian flu virus. Cases discovered by ILI surveillance are mild cases and discovered by pneumonia surveillance are severe cases. In the counties with laborato- ry confirmed cases reported,intensive surveillance should be carried out for a period of two weeks.
出处
《预防医学论坛》
2015年第5期342-345,353,共5页
Preventive Medicine Tribune
