2013-2018年南昌市重症肺炎病例中甲型流感病毒感染状况分析

Analysis of infection status in severe pneumonia cases infection with influenza A virus in Nanchang from 2013 to 2018

目的分析南昌市重症肺炎病例的甲型流感病毒分布特征和发病特点,为重症肺炎病例的临床防治提供依据。方法收集2013年4月～2018年3月南昌市重症肺炎病例的呼吸道样本和病例资料,进行病原学和流行病学分析。结果 2013年4月～2018年3月共检测来自南昌市17家医疗机构的261例重症肺炎病例,检出甲型流感病毒核酸阳性77例,总阳性率为29. 50%。其中包括39例新甲H1NI病例、13例季节性H3、16例人感染H7N9禽流感、3例人感染H10N8禽流感。甲型流感病毒重症肺炎病例主要发生在冬春季(12月至次年5月),年龄中位数48岁,其中男性48例,女性31例。2013-2018年南昌市报告21例人感染H7N9/H10N8禽流感病例,90. 48%(19/21)的病例通过不明原因肺炎监测发现,病死率33. 33%。结论南昌市重症肺炎病例中近三成感染甲型流感病毒,其中新甲H1NI流感病毒为主要流行株,死亡病例均为禽流感病毒感染。

Objective To explore the distribution and disease characteristics of influenza virus A in severe pneumonia cases in Nanchang city,so as to provide evidence for clinical prevention and treatment of severe pneumonia cases.Methods The respiratory samples and clinical case data of severe pneumonia cases were collected and the etiology and epidemiology were analyzed in Nanchang from April 2013 to March 2018.Results From April 2013 to March 2018,261 case patients of severe pneumonia from 17 medical institutions in Nanchang were enrolled.77 cases was detected as positive for influenza A virus nucleic acid,accounting for 29.50%of the total cases,as follow:39 cases of A(H1N1pdm)influenza,13 A(H3),16 H7N9 and 3 H10N8 avian influenza.Cases were mainly concentrated in winter and spring(from December to May of next year,with median age 48 of years,including 48 males and 31 females.21 cases of human infection with H7N9/H10N8 avian influenza were reported in Nanchang during 5 years,with the fatality rate of 33.33%.90.48%(19/21)cases were detected by unexplained pneumonia surveillance system.The median age was 69 years,most of them had underlying diseases and a clear history of poultry contact.Conclusions Nearly 30%of the severe pneumonia cases in Nanchang city were infected with influenza A virus,among which influenza A(H1N1pdm)virus was the main epidemic strain.All deaths were caused by avian influenza virus infection.