肇庆市2011-2014年流感和人禽流感监测结果分析  

Surveillance of influenza and human avian influenza in Zhaoqing,2011-2014

作　　者：朱碧柳[1] 黄国华[1] 麦炜 谭翰清[1] 黄旭东 吕灶群 陈志鹏[1] 周跃华[1] 

机构地区：[1]肇庆市疾病预防控制中心,广东肇庆526060 [2]高要市疾病预防控制中心

出　　处：《中国预防医学杂志》2016年第2期95-98,共4页Chinese Preventive Medicine

基　　金：2011年肇庆市科技创新计划项目(2011E388)

摘　　要：目的分析肇庆市流感和禽流感监测结果,为制定流感、禽流感防控策略提供科学依据。方法对2011-2014年肇庆市流感监测哨点医院流感样病例（influenza-like illness,ILI）就诊状况及病原学特征进行分析。采用马红细胞血凝抑制试验（HI）检测禽类职业暴露人群H5N1和H7N9血凝素抗体。采用荧光定量PCR法检测对市场环境样本进行A型流感病毒和H5、H7、H9亚型禽流感病毒核酸检测。结果2011-2014年流感哨点医院监测ILI共16 533例,占门诊就诊患者的1.18%;各年度ILI%分别为1.86%、1.09%、0.95%和1.01%。本研究检测样本3 272份,流感病毒阳性662份,阳性率20.23%。各年度流感病毒阳性率变化呈逐年上升趋势,差异有统计学意义（χ2=48.549,P〈0.01）。各年度流感毒株型别分布差异有统计学意义（χ~2=213.471,P〈0.01）,其中2011年主要为H1N1型（69.57%）;2012年以B型（50.78%）为主;2013年主要为H1N1型（48.18%）,2014年以B型（39.94%）和H3N2型（32.93%）为主。本研究采集职业暴露人群血清样本720份,检测血清H5N1血凝素抗体均为阴性,2013-2014年增加了检测H7N9抗体,结果均为阴性;采集市场环境样本642份,A型流感病毒核酸阳性样本124份,阳性率为19.31%。2011-2014年市场环境禽流感病毒均以H9亚型为优势,阳性率分别为52.38%、75.00%、57.81%、45.71%。结论 2011-2014年ILI%波动较大,流感病毒亚型不同,病毒阳性率呈逐年上升的趋势。在职业暴露人群中未发现禽流感H5和H7亚型隐性感染。活禽市场存在禽流感病毒污染,H5、H7、H9三者并存。Objective To analyze the results of influenza and human avian influenza surveillance in Zhaoqmg, and provide evidence for the development of influenza and human avian influenza prevention and control strate- gies. Methods Weekly numbers of influenza-like illness cases and weekly data of etiological surveillance from 2011 to 2014 were analyzed. Horse erythrocyte hemagglutination inhibition （HI） test was used to detect H5N1 and HTN9 hemagglutinin antibody in poultry exposure population, and Real-time PCR was employed to detect virus nucleic acid of avian influenza A and H5, H7, H9 subtypes in environmental samples. Results From 2011 to 2014, a total of 16 533 cases with influenza-like illness （ILl） were reported accounting for 1.18% of outpatients. 3 272 pharyngeal swab samples were tested with 20. 230/00 positive for influenza virus, which increased significantly by years. The dominate influenza virus subtypes varied with A （H1N1） （69.57%） in 2011, B （50.78%） in 2012, A （H1N1） （48.18%） in 2013, B （39.94%） and A （H3） （32.93%） in 2014. 720 serum samples collected from poultry exposure population were all negative for both H5N1 and HTN9 hemagglutinin antibodies. Among 642 environmental samples collected from markets, 19.31% were positive for avian influenza A virus. H9 avian influenza virus was dominant in environment with the positive rates of 52.38%, 75.00%, 57.81%, and 45.71% from 2011 to 2014. Conclusions Percenta ges of ILI cases fluctuate wildly from 2011 to 2014. The dominate influenza virus subtypes also vary great ly. The positive rate of influenza virus shows up-ward trend. H5 and H7 avian influenza virus infections are not found in occupational exposure population but avian influenza virus exists in poultry markets especially HS, H7 and Hg.

关 键 词：疾病监测 流感病毒 禽流感病毒 

分 类 号：R511.7[医药卫生—内科学]