浙江省德清县农村成人甲型流感各亚型病毒血清抗体检测及其关联探讨  

Serologic survey of influenza A viruses subtype H7N9,H9,H5,H1N1pdm09,H3 and H1 in rural area of Deqing,Zhejiang

作　　者：王学才[1] 吴照帆 董晓莲[1] Yue Chen 朱建福[1] 卫国荣[2] 熊海燕[2] 蒋露芳[2] 付朝伟[2] 姜庆五[2] 

机构地区：[1]浙江省德清县疾病预防控制中心,浙江德清313200 [2]复旦大学公共卫生学院流行病学教研室,公共卫生安全教育部重点实验室,上海200032 [3]加拿大渥太华大学医学院,Ontario K1H 8M5

出　　处：《疾病监测》2016年第2期120-125,共6页Disease Surveillance

基　　金：上海市公共卫生重点学科建设计划(No.12GWZX0101)~~

摘　　要：目的了解浙江省德清县农村社区成人禽流感病毒H7N9、H9、H5、甲型H1N1、季节性H1、H3的血清抗体水平,探索各亚型流感病毒之间的关联。方法 2013年4月德清县发现2例H7N9患者,分别在急性期和恢复期检测了患者及其家属的血清抗体;利用已有的生物样本库,检测病例发生之前收集的725份血清和病例发生之后收集的503份血清的H7N9、H9、H5的抗体水平,了解疫情前后人群血清抗体水平变化情况,在503份血清中抽取398份,检测甲型H1N1、季节性H1、H3的抗体情况,探索其与其他亚型流感病毒的关系;血清检测采用血凝抑制试验(HI),H7N9、H9、H5以HI抗体滴度≥1∶20为阳性,甲型H1N1和季节性H1、H3以≥1∶40为阳性,对于部分阳性和阴性样本进行复测;计算抗体阳性率和几何平均滴度,关联分析采用配对χ2检验并计算关联系数r。结果 H7N9的14名密切接触者中有2人抗体阳性,阳性率为14.3%;H7N9疫情出现之前,一般人群血清中未发现H7N9抗体(0/725),疫情出现之后发现1名隐性感染者,抗体阳性率为0.2%(1/503),H7N9疫情出现前后均未检出H5抗体,H9抗体阳性率没有明显变化,约为4.19%(22/503),标化率4.18%;甲型H1N1阳性率为4.77%(19/398),标化率5.73%;季节性H1为5.28%(21/398),标化率7.86%;季节性H3为11.31%(45/398),标化率6.28%;各个年龄组之间抗体阳性率差异无统计学意义;关联分析显示甲型H1N1血清抗体阳性者,H9血清抗体也趋于阳性(r=0.108,P<0.05);季节性流感病毒H1、H3抗体阳性者,甲型H1N1血清抗体也趋于阳性(r=0.504,P<0.05;r=0.111,P<0.05)。结论德清县农村社区一般人群对H7N9和H5无免疫力,对H9、甲型H1N1和季节性H3、H1免疫保护水平有限,需要重点监测和保护。甲型H1N1和季节性流感病毒H9可能存在抗体交叉保护或共同暴露。Objective To understand the seroprevalence of influenza A viruses subtype H7N9,H9 and H5,influenza A（ H1N1） pdm09 virus and seasonal influenza A viruses subtype H1 and H3 in rural area of Deqing county,Zhejiang province,and the correlation among the infections of different viruses. Methods A total of 1228 serum specimens,including 725 collected before the H7N9 epidemic in 2013 and 503 collected after the H7N9 epidemic,were tested for the antibody against subtype H7N9,H9 and H5. M eanwhile,398 of the 503 serum specimens collected after the H7N9 epidemic were also tested for the antibody against subtype H1N1pdm09 and subtype H1 and H3. Serum antibody were tested using hemagglutinationinhibition（ HI） and considered as positive with HI titer ≥1∶ 20 for subtype H7N9,H9,H5 and HI titer ≥1 ∶ 40 for subtype H1N1pdm09 and subtype H3, H1. The seroprevalence and geometric mean titers（ GM Ts） were calculated, and the correlation was analyzed with Paired χ2test. Results Among 14 close contacts of 2 H7N9 infection cases,2 were H7N9 virus positive（ 14. 3%）. Before the epidemic,no antibody against H7N9 virus was detected in general population（ 0 /725）. Afterthe epidemic,1 latent infection cases was detected（ 1 /503）. The rates of protective antibody against subtype H7N9,H9,H1N1pdm09,H1 and H3 were 0. 2%（ 1 /503）,4. 19%（ 22 /503）,4. 77%（ 19 /398）,5. 28%（ 21 /398） and 11. 31%（ 45 /398）,respectively,no antibody against subtype H5 was detected. No significant differences were observed in seroprevalence among different age groups. The results from the correlation analysis indicated that people infected with subtype H1N1pdm09 tended to have antibody against subtype H9（ r = 0. 108,P〈0. 05） and people who were positive for antibodies against subtype H3,H1 were more likely to be positive for subtype H1N1pdm09（ r = 0. 504,P〈0. 05; r = 0. 111,P〈0. 05）. Conclusion Our results showed that the general population in rural area in Deqing had no immunity to H7N9,H5 viruses and th

关 键 词：H7N9 H9 H5 甲型H1N1 人季节性流感 血清抗体检测 

分 类 号：R511.7[医药卫生—内科学]