浙江省三波人感染H7N9禽流感疫情流行特征与趋势分析  

Epidemiological characteristics and trend analysis of human infection with avian influenza A(H7N9)in Zhejiang

作　　者：程伟[1] 王笑笑[1] 刘社兰[1] 余昭[1] 陈恩富[1] 

机构地区：[1]浙江省疾病预防控制中心,浙江杭州310051

出　　处：《中国预防医学杂志》2016年第4期246-250,共5页Chinese Preventive Medicine

基　　金：浙江省医药卫生科技计划(2013KYA043;2014KYA034);浙江省科技计划项目(2014C03039)

摘　　要：目的分析浙江省2013年以来三波人感染H7N9禽流感疫情流行特点,探讨流行趋势,为其防控提供依据。方法通过个案调查的方法收集人感染H7N9禽流感患者的相关资料,应用SAS 9.2统计软件,采用χ2检验、秩和检验分析三波疫情流行特征的变化,P<0.05为差异有统计学意义。结果截至2015年7月2日,浙江省共确诊人感染H7N9禽流感患者184例,死亡73例。外环境监测表明,H7样本阳性率(r=0.45,P=0.02)和场所阳性率(r=0.50,P=0.01)在11月至次年2月最高,与发病时间分布一致。三波疫情中,患者在病死率(χ2=9.36,P=0.01),地区分布(χ2=6.71,P=0.03),活禽市场暴露(χ2=6.13,P=0.046),宰杀禽暴露(χ2=7.85,P=0.02),饲养禽暴露(χ2=13.69,P=0.00),职业暴露(χ2=8.73,P=0.01),发病至抗病毒治疗时间(H=9.99,P=0.01)上差异均有统计学意义,而在年龄(t=1.79,P=0.41),性别(χ2=0.47,P=0.79),职业(χ2=2.90,P=0.23),基础性疾病患病高血压(χ2=0.34,P=0.84)、糖尿病(χ2=3.01,P=0.22),直接接触禽类暴露(χ2=5.60,P=0.06),购买禽暴露(χ2=4.78,P=0.09),发病至就诊时间(H=4.45,P=0.11),发病至确诊时间(H=0.28,P=0.87),发病至住院时间(H=1.62,P=0.44)上差异均无统计学意义。结论由于外环境H7阳性持续存在,人感染H7N9禽流感患者将持续散发,应进一步加强城市地区活禽市场关闭的管理并重视农村地区活禽暴露和患者的救治问题。Objective To analyze the epidemiological characteristics and trend of human infection with avian influenza A（H7N9）among three groups of cases since 2013 in Zhejiang province,in order to provide the basis for future prevention and control. Methods Data of cases with H7N9 influenza were collected and analyzed by descriptive epidemiological method.SAS 9.2software was used for statistical analysis. Results As of July 2,2015,a total of 184 confirmed H7N9cases,including 73 deaths,were reported in Zhejiang province.External environmental monitoring showed that the sample positive rate and site positive rate for H7 were the highest from November to the next February,which were consistent with the distribution of the case onset.The correlation coefficients were 0.45 and 0.50,respectively.The differences of mortality（χ^2=9.36,P=0.01）,regional distribution（χ^2=6.71,P=0.03）,exposure to live poultry market（χ^2=6.13,P=0.046）,killing poultry exposure（χ^2=7.85,P=0.02）,breeding poultry exposure（χ^2=13.69,P=0.00）,occupational exposure（χ^2=8.73,P=0.01）,time from onset to antiviral treatment（H=9.99,P=0.01）were all statistically significant among three groups of cases,while,the differences were not significant in terms of age（t=1.79,P=0.41）,gender（χ^2=0.47,P=0.79）,occupation（χ^2=2.90,P=0.23）,hypertension prevalence（χ^2=0.34,P=0.84）,diabetes mellitus prevalence（χ^2=3.01,P=0.22）,direct contact with live poultry（χ^2=5.60,P=0.06）,purchasing live poultry（χ^2=4.78,P=0.09）,time from onset to treatment（H=4.45,P=0.11）,time from onset to diagnosis（H=0.28,P=0.87）,time from onset to hospitalize（H=1.62,P=0.44）. Conclusions Due to the continuing existence of positive H7 in the external environment,H7N9 case will continue to be sporadic in Zhejiang province.We should further strengthen the management of live poultry markets shut down in urban areas and recognize the importance of live poultry exposure and case treatment in rural areas so as to further reduce the inc

关 键 词：人感染H7N9禽流感 流行特征 趋势 分析 

分 类 号：R511.7[医药卫生—内科学] R181.3[医药卫生—临床医学]