惠州市首例人H7N9禽流感病例的实验室诊断与防控对策  

Laboratory diagnosis of first case of human infection with H7N9 avian influenza in Huizhou

作　　者：琚雄飞[1] 邹丽蓉[2] 何伟锋 郭家亮[1] 甘爱华 

机构地区：[1]惠州市疾病预防控制中心,广东惠州516003 [2]广东省疾病预防控制中心,广东广州511430 [3]惠州市整合医学重点实验室,广东惠州516001

出　　处：《中国热带医学》2015年第2期163-166,共4页China Tropical Medicine

基　　金：惠州市科技计划项目(No.2014Y100)

摘　　要：目的分析惠州市首例人感染H7N9禽流感病例病原学特征,了解人感染H7N9禽流感的流行规律,为制定防控措施提供依据。方法提取患者标本病毒核酸,利用荧光定量PCR进行检测,扩增HA和NA基因片段并进行序列分析。通过流感强化监测扩大人感染H7N9禽流感病例的主动筛选,采集活禽交易市场、禽类养殖场以及密切接触者标本开展病原学主动监测。结果该患者呼吸道标本甲型流感、H7亚型和N9亚型均为阳性,对血凝素和神经氨酸酶基因序列进行比对和进化分析,显示该H7N9禽流感病毒HA基因与NA基因与已公布的人感染H7N9禽流感病毒序列高度同源。96名密切接触者均未发现感染H7N9禽流感病毒。通过流感强化监测,严重急性呼吸道感染病例274例,发现4例人感染H7N9禽流感病例。活禽交易市场外环境和禽类标本检出3份H7N9禽流感病毒核酸阳性。结论惠州首例H7N9禽流感病例病毒HA及NA特征基因序列与国内流行的病毒株高度同源,未发现人传人的迹象,存在禽类携带及外环境污染H7N9禽流感病毒的情况。通过流行病学调查分析和病原学监测来逐步揭示H7N9禽流感病毒的流行特征和传播途径,为制定科学合理的防控策略提供依据。Objective To analyze pathogenic and epidemiological characteristics of first case of human infection withavian influenza（H7N9）virus in Huizhou City so as to provide evidence for future prevention and control. Methods Viral RNAwas extracted from patients and detected by real-time RT-PCR. HA and NA gene segments were amplified and sequenced. Byexpanding surveillance on the suspected cases in adults, samples from close contacts, the live poultry markets and the livepoultry breeding plants were detected to analyze the pathogenic characteristics. Results The specimens of influenza type A,subtype H7 and subtype N9 were all detected positive. The results of sequence alignment and phylogenetic analysis ofhemagglutinin and neuraminidase revealed high homology with that of currently epidemic H7N9 subtype viruses in Chinesemainland. No infections were detected from the 96 close contacts. By expanding surveillance on 274 SARI cases, 4 cases werefound to be positive for H7N9 virus. However, 3 specimens from external environment of live poultry market and bird feceswere detected to be negative for H7N9 positive. Conclusion The gene sequence of HA and NA of first case of H7N9 avianinfluenza virus had high homology with the currently epidemic virus in Chinese mainland. There was no evidence ofinterpersonal transmission of H7N9 infections. The viruses were found from bird and external environmental pollution.Epidemiological investigation and pathogenic monitoring be adopted to reveal the epidemic characteristics and transmissionroutes.

关 键 词：H7N9禽流感病毒 流行病学 序列分析 防控策略 

分 类 号：R511.7[医药卫生—内科学]