3895例流感样病例病原学检测及流行病学特征分析

Pathogenic detection and epidemiological analysis of 3 895 influenza like cases

目的 了解本地区流感样病例(influenza like illness, ILI)咽拭子标本流感病毒病原学检测结果及流行特征。方法 选取2021-2023年本地区流感监测哨点医院收集的流感样病例的咽拭子标本,进行病原学检测,对比不同年份、不同性别、不同年龄、不同季节病毒标本阳性率及不同病毒分型构成比。结果 共报告ILI标本3 895份,检出流感病毒阳性标本481份,阳性率12.35%。2021年阳性率为7.98%(85/1065),2022年阳性率为10.77%(129/1198),2023年阳性率为16.36%(267/1632),不同年份病毒阳性率差异有统计学意义(P<0.05)。481份病毒阳性标本中,126份检出甲型H1N1,189份甲型H3N2,154份乙型Victoria系,12份乙型Yamagata系。2021年85份流感病毒阳性标本,主要为甲型H3N2(41.18%,35/85);2022年129份流感病毒阳性标本,主要为乙型Victoria系(51.16%,66/129);2023年267份流感病毒阳性标本,主要为甲型H3N2(42.70%,114/267)。不同年份,甲型H3N2构成比差异无统计学意义(P>0.05),甲型H1N1、乙型Victoria系、乙型Yamagata系构成比差异有统计学意义(P<0.05)。男性阳性率11.95%(256/2142),女性为12.84%(225/1753),不同性别间差异无统计学意义(P>0.05)。不同性别间,甲型H1N1、甲型H3N2、乙型Victoria系、乙型Yamagata系构成比差异无统计学意义(P>0.05)。0~<5岁患者阳性率4.97%(17/342);5~<15岁为13.57%(78/575);15~<25岁为12.17%(82/674);25~<60岁为13.99%(253/1808);≥60岁为10.28%(51/496)。不同年龄段患者,病毒阳性率差异有统计学意义(P<0.05)。春季患者阳性率15.65%(165/1054),夏季为1.80%(14/779),秋季为3.21%(28/873),冬季为23.04%(274/1189)。不同季节发病患者病毒阳性率差异有统计学意义(P<0.05)。结论 2021-2023年本地区流感样病例咽拭子标本流感病毒主要为甲型H3N2,冬春季节为主要流行季节。不同年份、不同年龄、不同季节的病毒阳性率及流行的优势菌株具有差异性。

Objective Toanalyze the influenza virus pathogen detection results and epidemic characteristics of throat swab samples from Influenza like illness in the local area. Methods The throat swab samples of influenza like illness cases were collected from local influenza monitoring sentinel hospitals from 2021 to 2023 for pathogen testing.The positive rates of virus specimens and the composition ratios of different virus subtypes were compared in different years, genders, ages, and seasons. Results A total of 3 895 ILI specimens were reported, and 481 influenza virus positive specimens were detected, with a positive rate of 12.35%. The positivity rate of influenza virus in 2021 was 7.98%(85/1065),in 2022 it was 10.77%(129/1198),and in 2023 it was 16.36%(267/1632). The difference in virus positivity rates among different years was statistically significant(P<0.05). There were 481 virus positive specimens, including 126 type A H1N1,189 type A H3N2,154 type B Victoria strain and 12 type B Yamagata strains. In 2021,there were 85 influenza virus positive specimens, mainly typeA H3N2(41.18%,35/85);In 2022,there were 129 influenza virus positive specimens, mainly the type B Victoria strain(51.16%,66/129);267 influenza virus positive specimens were obtained in 2023,mainly consisting of type A H3N2(42.70%,114/267). In different years, there was no statistically significant difference in the composition ratio of type A H3N2(P>0.05),while there was a statistically significant difference in the composition ratio of type A H1N1,type B Victoria, and type B Yamagata(P<0.05). The positivity rate of influenza virus in male specimens was 11.95%(256/2142),while in female specimens it was 12.84%(225/1753). There was no statistically significant difference between different genders(P>0.05). There was no statistically significant difference(P>0.05) in the composition ratio of type A H1N1,type A H3N2,type B Victoria, and type B Yamagata among different genders. The positivity rate in patients aged 0 to 5 years old was 4.97%(17/342);in patients aged 5 to 15 years old it was 13.57%(78/575);in patients aged 15 to 25 years old it was 12.17%(82/674);in patients aged 25 to 60 years old itwas 3.99%(253/1808);in over 60 year old patients it was 10.28%(51/496). The difference in virus positivity rates among patients of different age groups was statistically significant(P<0.05). The positive rate in spring onset patients was 15.65%(165/1054),in summer onset patients it was 1.80%(14/779),in autumn onset patients it was 3.21%(28/873),and in winter onset patients it was 23.04%(274/1189). The difference in virus positivity rates among patients with different seasons of onset was statistically significant(P<0.05). Conclusion From 2021 to 2023,throat swab specimens of influenza like cases in this region showed that the influenza virus was mainly type A H3N2,with winter and spring being the main epidemic seasons. The positivity rate and dominant strains of the virus vary among different years, ages, and seasons.