江西省首例儿童禽流感H9N2亚型病例的调查分析  

The first case of children's H9N2 subtype avian influenza in Jiangxi Province

作　　者：乐高钟[1] 吴小秧[1] 易爱兰 罗勤[1] 冯秀 游胜 

机构地区：[1]江西省萍乡市人民医院儿科,江西萍乡337055 [2]江西省萍乡市疾控中心,江西萍乡337055

出　　处：《现代预防医学》2017年第5期785-787,792,共4页Modern Preventive Medicine

摘　　要：目的明确人感染禽流感疫情,查明其感染来源,采取有效措施控制疫情。方法采用现场流调和实验检测相结合的方法对萍乡市1例儿科门急诊发热病例进行筛查、诊断和分析。结果该患儿女性,4岁,于2016年8月2日开始发病,病初表现为流感样症状,反复高热2天,在家口服抗生素等药物治疗无效于2016年8月4日晚上来院就诊,经过抗病毒等有效治疗于2016年8月12日痊愈。患儿咽拭子标本禽流感病毒(H9N2)核酸阳性,病毒分离阳性,基因系列分析显示,分离的H9N2病毒[A/Jiangxi/1/2016/(H9N2)]仍为禽源性特征。患儿发病前后未离开过居住地,未接触过类似病人,但发病近2周有禽类及产品接触史。经医学观察一周,所有密切接触者(包括患儿直系家属共58人)均未出现类似症状。参照卫生部禽流感防控应急预案,采取相应防控措施,疫情没有扩散。结论该病例确诊为江西省首例人感染低致病性禽流感,感染来源可能是禽流感病毒(H9N2)从家禽中获得,无人传人的现象。该例患儿是在我院作为国家流感监测哨点医院日常监测工作中被发现,提示今后应继续加强流感疫情监测工作,加强人感染禽流感的应急贮备、培训和健康宣教。Objective To confirm a case infected with avian influenza A（ H9N2） and detect some risk factors and infectious source,to control the spread of infection with the H9N2 virus in human. Methods Field investigation and laboratory test were implemented. Epidemiological,clinical and virological data of the case of fever in pediatric outpatient emergency treatment were collected and analyzed. Results The patient was female,aged 4 years old,had influenza-like onset on August 2,2016. At the beginning of the disease,the case was characterized by flu-like symptoms,repeatedly showed high fever for 2 days,and oral antibiotics drug treatment was invalid at home. The cases Pharyngeal swab specimens were tested positive for H9N2 by RT-PCR and by viral culture [A/Jiangxi/1/2016/（ H9N2） ]. After antiviral and other effective treatment,the case was healed on August 12,2016. Before and after the onset,the case didn＇t leave the residence,and was not exposed to similar patients,but nearly 2 weeks has been to poultry markets play. There were selling their residences egg business activities. All 58 close contacts under daily surveillance for 8 days had no clinical symptoms. Controlling measures were put forward to effectively prevent the potential spread. Conclusion The human case infected with low pathogenic avian influenza A（ H9N2） virus in 2016 was the first one diagnosed and reported in Pingxiang city of Jiangxi Province. This local case may be infected by indirect contact with sick or carry poultry. And there was no evidence of person-person transmission. The case as a national influenza surveillance sentinel hospital daily monitoring in the work was found in our hospital,reminding it should be strengthened to improve the surveillance and emergency response,and to enhance training and health education for prevention and control of human pathogenic avian influenza.

关 键 词：流感病毒A型 H9N2亚型 感染 儿童 

分 类 号：R181.23[医药卫生—流行病学]