中国确诊的首例儿童H7N9禽流感  

The first confirmed pediatric case with H7N9 avian influenza virus infection in China

作　　者：曾玫[1] 朱燕凤[1] 葛艳玲[1] 夏爱梅[1] 浦东波[1] 俞蕙[1] 王晓红[1] 朱启镕[1] 

机构地区：[1]复旦大学附属儿科医院感染科,上海201102

出　　处：《中华儿科杂志》2013年第9期665-669,共5页Chinese Journal of Pediatrics

摘　　要：目的探讨儿童H7N9禽流感的临床表现和流行病学特征。方法收集国内确诊的首例儿童感染H7N9禽流感病例流行病学信息、临床症状、实验室资料、治疗和转归。结果患儿既往健康，年龄3．6岁，居住上海农村。2013年3月31日出现发热和流涕，4月3日以后体温正常。4月1日在全国流感监测中采集的鼻咽拭子标本用实时荧光逆转录PCR和病毒分离都检测到H7N9病毒。患儿家庭饲养的家禽无疾病发生和H7N9感染的病毒学证据。对其16名接触者进行监测未发现继发感染病例。结论儿童感染H7N9禽流感相对成人病情较轻，儿童感染暴露源尚不清楚。持续监测轻症、重症呼吸道感染以及亚临床感染对于深入了解儿童H7N9病毒感染的流行病学和临床疾病谱特征是必要的。Objective To understand the clinical and epidemiological aspects of avian influenza A （HTN9） virus infection in children. Method The clinical data of the first confirmed pediatric case of avian influenza A （H7N9） virus infection were collected, and the epidemiological information, presenting symptoms, laboratory investigation, management and outcome were analyzed. The data of the pediatric cases were also compared with those of the adults cases. Result The case reported in this paper was a previously healthy 3.6-year-old boy residing in rural area of Shanghai. He had onset of fever and mild rhinorrhea on 31 March 2013 and he was afebrile and well since April 3. Influenza A （ HTN9 ） virus was detected in his nasopharyngeal sample collected on 1 April through national Influenza-like Illness surveillance using real- time reverse transcriptase PCR and virus culture. His family raised domestic poultry with no apparent disease and there was no virological evidence of H7N9 infection. Monitoring and testing of 16 contacts had not found any secondary infection. Conclusion The clinical course of H7N9 avian influenza virus infection in children was relatively mild as compared to adult cases. The source of infection and detail of exposure for children have not been known yet. Continued surveillance studies of mild and severe respiratory disease and subclinical infection are essential to further characterize the epidemiology and clinical spectrum of this emerging HTN9 virus infection in children.

关 键 词：禽流感 H7N9禽流感 儿童 

分 类 号：R725.1[医药卫生—儿科]