上海市某哨点医院2013—2015年儿童流行性感冒病原学监测分析  

Etiological analysis of influenza in children from a sentinel surveillance hospital in Shanghai during 2013-2015

作　　者：王平[1] 赵文良[1] 蔡明毅[1] 沈琦[1] 任静[1] 何永频[1] 

机构地区：[1]上海市静安区疾病预防控制中心,上海200041

出　　处：《微生物与感染》2016年第6期362-365,共4页Journal of Microbes and Infections

基　　金：上海市静安区卫生和计划生育委员会重点学科项目(JWXK201203)

摘　　要：为了解上海市儿童流行性感冒（简称流感）的流行特征,为儿童流感防控提供实验室依据,本研究按《全国流感监测方案》和《流行性感冒病毒及其实验技术》要求,对上海市某哨点医院2013-2015年采集的流感样患儿标本,采用实时反转录―聚合酶链反应（reverse transcriptase―polymerase chain reaction,RT―PCR）进行核酸检测.共采集咽拭子标本3359份,检出540份流感病毒阳性,阳性率为16.08%.其中甲型H3流感病毒阳性277例,乙型流感病毒阳性158例,甲型H1N1流感病毒阳性105例.2013-2015年流感病毒检出率依次为10.02%、19.02%和20.81%.阳性率高峰出现在2013年12月-2014年2月（41.77%~64.58%）、2014年7-9月（16.67%~23.29%）、2015年1-3月（35.14%~44.74%）、2015年7-8月（32.65%、40.23%）及2015年12月（41.49%）.1.0岁以下婴儿检出率最低,为7.67%;7.0岁以上最高,为31.83%（148/465）.监测结果显示,流感在冬春季和夏秋季均有一个流行高峰,其中乙型和甲型H1N1流行高峰为冬春季,夏秋季流行高峰主要为甲型H3.引起流感的优势病原亚型在2014年由甲型H3转变为甲型H3/乙型.结果提示,该哨点医院儿童流感的优势病原亚型自2014年开始发生明显改变,应加强对乙型流感等的监测.The present study aims to investigate the epidemiological characteristics of influenza in Shanghai children during 2013―2015 ,and to provide evidence―based data for influenza control and prevention .The throat swab samples were collected from the influenza―like cases at a sentinel surveillance hospital in Shanghai during 2013―2015 ,according to the National Influenza Surveillance Program and Influenza Virus and Experimental Technology . The samples were subjected to real―time reverse transcriptase―polymerase chain reaction （RT―PCR） for influenza virus detection .A total of 3359 samples were collected during 2013―2015 ,and 540 samples were influenza virus―positive ,including 105 influenza A （H1N1） ,158 influenza B and 277 H3 subtype ,with a positive detection rate of 16 .08% .The positive rates of influenza virus were 10 .02% ,19 .02% and 20 .81% in 2013 ,2014 and 2015 ,respectively .The detection rate was the lowest （7 .67% ） in the infants younger than 1 .0 year and the highest （31 .83% ） in the children older than 7 .0 years .The results showed that the peak of influenza epidemic appeared twice in one year . The peak of detection rate of influenza B and H1N1 appeared in winter and spring （December to March ） ,whereas the peak in July to September was caused by H3 .The predominant type of influenza virus changed from H3 to H3 and B after 2013 .The results suggest that the predominant subtype of influenza virus in children has changed after 2013 in this sentinel surveillance hospital ,and the monitoring of influenza B should be strengthened .

关 键 词：流行性感冒 儿童 H3亚型 H1N1 

分 类 号：R725.1[医药卫生—儿科] R181.3[医药卫生—临床医学]