跨省流动H5N1人禽流感病例应急监测分析  

Analysis of emergency surveillance results of an avian influenza (H5N1) case with interprovincial floating history

作　　者：谢朝军[1] 刘于飞[1] 蔡文锋[1] 潘捷云 刘青连 肖晓玲 陆剑云[1] 刘建平[1] 马晓薇[1] 刘艳慧[1] 李魁彪[1] 袁俊[1] 

机构地区：[1]广州市疾病预防控制中心,广东广州510440 [2]海珠区疾病预防控制中心,广东广州510305 [3]越秀区疾病预防控制中心,广东广州510055

出　　处：《现代预防医学》2014年第13期2450-2453,共4页Modern Preventive Medicine

基　　金：2011年度广州市医药卫生科技项目(201102A213219)

摘　　要：目的分析一例跨省流动H5N1人禽流感病例应急监测结果,为人禽流感疫情的应急监测工作提供参考。方法对病例密切接触者、可疑暴露市场的禽类从业人员实施症状和危险因素监测,设立应急监测医院进行流感样(Influenza Like Illness,ILI)病例监测。采集密切接触者、可疑市场禽类从业人员和应急监测搜索的ILI病例的咽拭子、血清标本进行禽流感病毒(H5、H7和H9亚型)核酸与抗体检测;采集可疑市场外环境标本检测禽流感病毒(H5、H7、H9亚型)核酸。结果23名密切接触者、34名禽类从业人员和应急监测搜索8名ILI的人禽流感H5亚型核酸和抗体检测结果均为阴性。病例发病期间,100%(23/23)的密接者曾在距病例1米范围内工作,其中73.68%(14/19)医护人员密接者仅戴一次性纺纱口罩和手套,100%(4/4)家属密接者无防护措施。销售或宰杀禽类时,23.53%(8/34)的禽类从业人员穿戴一次性纺纱口罩与工作衣,32.35%(11/34)的戴手套。应急监测医院ILI病例就诊百分比低于同期哨点监测医院(3.87%VS 6.99%,χ2=525.03,P<0.05)。禽类从业人员禽流感病毒H9亚型血清阳性率为6.06%(2/33);市场外环境标本禽流感病毒H5亚型核酸阳性率为4.42%(5/113),H9亚型阳性率为0.88%(1/113)。结论本起疫情未发现新发或续发病例。密接者与市场禽类从业人员的防护意识欠缺。禽类从业人员中未检出禽流感病毒H5亚型感染,但存在H9亚型感染;市场外环境存在H5和H9亚型感染。Objective To analyzed the data from the emergency surveillance of an avian influenza（H5N1） case with inter-provincial flowing history, so as to provide the reference for effective control and prevention of the disease. Methods Symptomatic and risk factors surveillance of close contacts and poultry employees, and emergency monitoring of ILI were conducted. Swabs and serum samples were collected to detect nucleic acid and antibody of avian influenza virus（H5, H7 and H9）, external environment specimens from the suspicious markets were detected for nucleic acid of avian influenza virus（H5, H7 and H9）. Results The laboratory results showed that nucleic acid and antibody of Avian influenza virus（H5） were negative in 23 close contacts, 34 poultry employees and 8 ILIs. During the incubation period, 100%（4/4） close contacts worked within 1 meter from the infector, 73.68%（14/19） of medical staffs only worn disposable spinning masks and gloves, and 100%（4/4） of families did not take protective measures. When selling or slaughtering poultry, only 23.53%（8/34） of poultry employees worn disposable spinning masks and work clothes. Outpatient rate of ILI patients was lower than that of sentinel surveillance hospitals in the same period（3.87% VS 6.99%, χ2=525.03,P〈0.05）. The antibody positive rate of H9 avian influenza was 6.06%（2/33） among poultry employees, and the nucleic acid positive rates of H5 and H9 avian influenza virus were 4.42%（5/113） and 0.88%（1/113） in the external environment. Conclusion No new or secondary cases were found after the reported case. Close contacts and poultry employees are lacked of awareness of personal protection. H5 antibody among poultry employees is not detected, but H9 antibody is found. H5 and H9 virus nucleic acid are both detected in the external environment.

关 键 词：禽流感 监测 流感样病例 

分 类 号：R181.8[医药卫生—流行病学]