一起水禽H5N1疫情暴发后人群感染风险评估  

Risk assessment of H5N1 human infection after an outbreak of avian influenza in water fowl

作　　者：王玉林[1] 刘于飞[1] 蒋力云[1] 柳洋[1] 杨智聪[1] 郝爱华[1] 伍业健[1] 李海麟[1] 李铁钢[1] 王鸣[1] 

机构地区：[1]广州市疾病预防控制中心,510080

出　　处：《中华预防医学杂志》2009年第1期41-44,共4页Chinese Journal of Preventive Medicine

基　　金：基金项目：广州市科技研究基金（200523-E0611,200623-E5141）

摘　　要：目的评估动物禽流感疫情暴发后人群感染的风险，探讨禽流感传播的可能性。方法采用现场流行病学调查、分子流行病学、血清学研究及应急监测方法，对病、死禽的所有密切接触者进行医学观察；采用红细胞凝集抑制实验、实时荧光逆转录-聚合酶链式反应（RT—PCR）、基因测序方法，检测全部密切接触者的血清抗体，采集4个疫点环境标本检测禽流感H5核酸。结果检测4个疫点环境标本22份，H5核酸阳性1份，序列分析与广州市2006年人禽流感病毒株A／China／GD01／2006（HSNl）的同源性为95．9％；检测疫区及周边2个农贸市场活禽交易场所环境标本62份，H5核酸均阴性；采集密切接触者的血样68份、咽拭子68份，禽流感H9抗体阳性6份，H5抗体、H5核酸均阴性，医学观察7d，未发现禽流感感染者；应急监测区报告流感样患者337例，经排查未发现可疑禽流感患者。结论此起水禽H5N1暴发未造成扩散，也未出现人感染病例，表明此次疫情的禽流感病毒H5N1对人的传播能力尚不强，引起人群感染的风险较低。Objective To evaluate the risk of human infection after the outbreak of avian influenza H5N1 in animals, and probe the possibility for virus transmission. Methods By means of field epidemiological study, molecular epidemiology, serology and emergency surveillance, persons who had ever closely contacted with sick or dead poultry were observed. While, the RT-PCR and gene sequencing method were used to detect I-IS nucleic acid from environmental swabs from 4 epidemic spots, and hemagglutination inhibition assay was also used to detect H5 antibody. Results Of 22 environmental swabs detected from 4 epidemic spots ,one was positive for H5 nucleic acid, and the homogeneity was 95.9% as compared with H5N1 virus A/China/GD01/2006 （HSN1） found in Guangzhou in 2006 by gene sequence analysis. 62 environmental swabs from live poultry stalls of food markets near epidemic spot were detected negative. Six of 68 blood samples of contacts were positive for H9 antibody, and all were negative for I-IS antibody. 68 throat swabs of contacts were detected negative for I-IS nucleic acid. No close contact was found abnormal after 7 days medical observation. 337 influenza-like cases were reported in emergency surveillance, and no suspicious case was found. Conclusion The current outbreak of H5N1 avian influenza in water fowls has not yet caused further transmission, and human avian influenza case has not been observed. It indicates that the ability of H5N1 virus to transmit to human is not strong yet,and the risk of human infection for H5N1 is still low.

关 键 词：禽流感 接触者追踪 疾病传播 危险性评估 

分 类 号：R686[医药卫生—骨科学]