哈尔滨市某医院2012—2017年儿童流感病原学监测结果分析

Analysis of influenza pathogenicity monitoring results in Harbin children's hospital,2012-2017

目的对哈尔滨市儿童医院2012—2017年流感病原学监测资料进行分析,掌握其流行规律、病毒分型及活动水平,为儿童流感的防控工作提供科学依据。方法采集哈尔滨市儿童医院0～14岁流感样病例(ILI)患儿的咽拭子标本,采用Real-timePCR方法,对ILI患儿咽拭子标本检测,阳性标本进行流感病毒分离,并用血凝抑制试验进行流感病毒型别的鉴定,进行流行病学分析。结果共采集3 528份0～14岁ILI患儿咽拭子标本,阳性标本309份,阳性率8.76%。2017年检出率最高(15.38%),2015年检出率最低(3.79%),各年流感阳性检出率差异有统计学意义(χ~2=63.845,P<0.01)。检出流感病毒由新甲H1、季H3和B型组成,各年型别构成比差异有统计学意义(χ~2=176.789,P<0.01);儿童与成人同期阳性检出率差异有统计学意义(χ~2=5.387,P<0.05)。3～5岁年龄组检出率最高,为10.99%,6～8岁组阳性检出率为9.57%,9～11岁组阳性检出率为9.33%,<3岁组检出率最低,为5.82%。流感流行高峰在每年的12月份至次年的4月份,检出的病毒数占病毒总数的97.77%。结论哈尔滨市近年儿童流感在不同年度流行型别存在差异,呈现交替流行,且流行强度存在差异。托幼儿童及中小学生为流感病毒易感的高危人群。冬春季节为流感的高发季节,且近年春季呈现高发趋势。

Objective To analyze the monitoring data of influenza etiology in Harbin children’s hospital from 2012 to 2017,master its regularty of epidemic,virus classification and activity level,provide scientific basis for the prevention and control of influenza among children.Methods The specimens of pharynx swabs of influenza-like illness(ILI)children aged 0 to 14 years in Harbin Children’s Hospital were collected.The Real-time PCR method was used to detect the swabs of children with ILI,and the positive specimens were isolated from the influenza virus,and the hemagglutination test was used.The type of influenza virus identification was performed and epidemiological analysis was performed.Results A total of 3 528 pharyngeal swabs of ILI aged 0 to 14 years were collected.Three hundred and nine of them were positive,with a positive rate of 8.76%.The detection rate was the highest in 2017(15.38%)and the lowest in 2015(3.79%).There were significant differences in the positive rate of influenza in each year(χ~2=63.845,P<0.01);the detected influenza viruses were composed of new H1,seasonal H3 and B,and the proportion of influenza viruses in each year was also significant(χ~2=176.789,P<0.01);the positive rate of children and adults in the same period was also significant(χ~2=5.387,P<0.05).The highest positive rate was found in the age group of 3 to 5 years(10.99%),9.57%in the age group of 6 to 8 years,9.33%in the age group of 9 to 11 years and 5.82%in the age group of less than 3 years.The peak of influenza epidemic was from December to April of the following year.The number of virus detected accounted for 97.77%of the total number of viruses.Conclusion In recent years,the epidemic types of influenza among children in Harbin are different in different years,showing alternate epidemics,and the epidemic intensity is different.Nursery children and primary and secondary school students are high-risk groups with influenza virus susceptibility.Winter and spring are the seasons of high incidence of influenza,and there is the trend of high incidence in spring in recent years.