广州市首例人禽流感病例流行病学调查  

EPIDEMIOLOGICAL INVESTIGATION OF THE FIRST HUMAN CASE OF HIGHLY PATHOGENIC AVIAN INFLUENZA IN GUANGZHOU

作　　者：刘北燕[1] 范建文[2] 张瑞丹[2] 何国宽[2] 张建华[2] 

机构地区：[1]安徽省安庆市卫生局卫生监督所,安庆246003 [2]广州市荔湾区疾病预防控制中心

出　　处：《现代预防医学》2008年第7期1219-1220,1223,共3页Modern Preventive Medicine

摘　　要：[目的]探讨人禽流感的感染来源和传播途径。[方法]应用现场流行病学、血清学调查的方法,对病例和密切接触者进行访谈;采用荧光定量PCR检测禽流感病毒H5核酸、酶链免疫吸附试验及血凝抑制试验检测禽流感H5抗体。[结果]患者发病前1个月未离开过广州,发病前两周多次到过肉菜市场活动,并在活禽销售场所附近有过较长时间的逗留,无病、死禽的接触史;病情变化凶险,迅速进展为全肺炎和呼吸衰竭、多器官功能衰竭;发病d8、9气管吸取物检出禽流感病毒H5核酸;56名密切接触者经过医学观察未发现被感染。[结论]该病例为本地感染,感染来源可能与其市场活动有关,但感染途径、感染方式尚不祥;在潜伏期末和发病期间经密切接触未造成人与人的传播。[Objective] To explore the epidemiological characteristics and source of infection of highly pathogenic avian influenza in human. [ Methods] Field epidemiological and serological investigation methods were used. The patient and his close contact persons were interviewed. A/H5 nucleic acid was tested by fluorescent quantitative PCR. H5 Specific antibody was tested by hemagglutination inhibition test. [ Results] The patient never left Guangzhou in one month before disease onset, but he went to markets manv times and stayed near live poultry stalls for relatively long time during two weeks before disease onset. No contact history with dead or diseased poultry was found. The patient was in a critical condition and rapidly developed bilateral pneumonia, respiratory failure and multiple organ failure. A/H5 nucleic acid was positive in trachea aspirates collected onthe 8th and 9th day after disease onset. A total of 56 close contact persons were carried out medical observations but no one was infected. [Conclusion] This case of human infection with highly pathogenic avian influenza is locally acquired. The source of infection may be related to the patient＇s activities in the markets, but the transmission route and manner are still unclear. Direct contact at the end of incubation period and during the period of onset through flying droplets, saliva, mucous menubrane and skin injuries will not lead to human to human transmission.

关 键 词：人禽流感 流行病学调查 感染来源 传播途径 

分 类 号：R535[医药卫生—内科学]