杭州市2例人感染H7N9禽流感患者流行病学调查分析

Epidemiological investigation and analysis of 2 cases of human infections with avian influenza A( H7N9) virus in Hangzhou

目的探讨杭州市2016年12月-2017年1月报告的2例确诊人感染H7N9禽流感患者的流行病学特点,追溯患者可能的感染来源,总结分析在对患者的流行病学调查过程中发现的问题和不足。方法对2例患者进行流行病学调查分析,采集相关外环境样本进行实验室检测,利用Real-time RT-PCR方法检测H7N9禽流感病毒核酸。结果调查显示,2例患者有明确的农贸市场暴露史或禽类接触史。在2例患者暴露的农贸市场或家庭散养活禽中检出H7N9阳性标本,密切接触者均未出现不适症状。在调查过程中发现存在患者首诊漏诊、延误病情等现象。结论 2例患者感染与农贸市场及禽类有关,应进一步提高基层医务人员的诊疗意识和医疗机构的检测能力,加强对农贸市场活禽交易和农村散养禽的管理,重视对农户禽流感防控知识的健康宣教。

Objective To analyze the epidemiological characteristics of 2 cases of human infection with influenza A（ H7 N9）virus in Hangzhou during December 2016-January 2017,identify the possible infection sources,and summarize the problem shortage discovered in the epidemiological investigation process. Methods Epidemiological analysis was conducted on the 2 cases,and external environment samples were collected for laboratory testing. The H7 N9 DNA was detected using Real-time RT-PCR. Results The analysis suggests that the 2 cases had obviously exposure to farm market or poultry. Positive H7 N9 viral nucleic acid sample was detected from the farm market or live poultry to which the patients had been exposed. No abnormal symptoms were found in the people close contacted with 2 patients. In the course of investigation,it was found that there were missed diagnosis and delayed illness. Conclusion The 2 cases of infection are closely related to farm markets and poultry,indicating that the diagnosis consciousness and detection ability of medical staff need to be improved,and the management of alive poultry markets and health education of prevention knowledge need to be strengthened.