广东省2013—2018年人感染H7N9和H5N6禽流感流行病学及临床特征分析

Epidemiological and clinical characteristics of human infections with avian influenza A(H7N9)and A(H5N6)viruses in Guangdong province,2013-2018

目的分析广东省2013—2018年人感染H7N9及H5N6禽流感病例的监测数据及临床资料.方法以2013—2018年人感染H7N9及H5N6禽流感确诊病例为对象,对疫情的基本情况、三间分布、暴露史、聚集性及临床特征等进行统计分析.结果发现人感染H7N9病例259例,病死率为38.6%;人感染H5N6病例8例,病死率为62.5%.病例主要发生在11月至次年4月,主要集中在珠三角地区.H7N9病例多见于男性,H5N6病例女性居多.245例H7N9病例(94.6%)及7例H6N6(87.5%)有直接或间接活禽接触史.广东省H7N9病例有6起聚集性病例.H7N9及H5N6病例多为重症病例,从发病到使用奥司他韦时间的中位数均在5 d以上.结论广东省人感染H7N9及H5N6禽流感的流行特征和临床特征不同,应做好不同亚型人禽流感病例的早期发现和干预,防止疫情的传播和流行.

Objective To analyze the epidemiological and clinical characteristics of human infections with avian influenza A(H7N9)and A(H5N6)viruses between 2013 and 2018 in Guangdong province.Methods The confirmed human infections cases of avian influenza viruses reported between 2013 and 2018 were used as research subjects.The basic information,disease distribution,exposure history,disease clustering and clinical characteristics were analyzed by statistical methods.Results A total of 259 human infection cases of influenza A(H7N9)virus were confirmed with the fatality rate of 38.6%.Eight human infection cases of influenza A(H5N6)were confirmed with the fatality rate of 62.5%.Most of the cases occurred from November to April and in the Pearl River Delta.The cases of influenza A(H7N9)virus infection were more common in male patients while the cases of influenza A(H5N6)infections were more common in female patients.Direct or indirect exposure to live poultry were obsevered in 245 influenza A(H7N9)virus infection cases(94.6%)and 7 influenza A(H5N6)virus infection cases(87.5%).There were six clusters of influenza A(H7N9)virus infection cases in Guangdong province.Regarding the clinical severity,most of the cases were severe,and the median value of time interval from onset to oseltamivir treatment were more than five days.Conclusions The epidemiological and clinical characteristics of humans infections with avian influenza A(H7N9)and A(H5N6)viruses were different in Guangdong province.Early detection and intervention of humans infections with different subtypes of avian influenza viruses should be enforced to prevent and control the spreading and epidemics of human infections with avian influenza viruses.