一起由3C.2a1分支甲型H3N2亚型流感病毒引起的医院暴发疫情分析  

Epidemiological survey of influenza A/H3N23C.2a1 clade outbreak in a hospital

作　　者：张海艳[1] 徐文彩[1] 周艳丽[1] 张惺惺[2] 崔淑娟[2] 赵彦珍 赵楠[1] 许宝麟 李源菁 王威[1] 杨鹏[2] 王全意[2] 

机构地区：[1]北京市东城区疾病预防控制中心流行病科,100009 [2]北京市疾病预防控制中心传染病地方病控制所

出　　处：《国际病毒学杂志》2017年第5期346-350,共5页International Journal of Virology

摘　　要：目的 通过对某医院一起甲型H3N2亚型流感暴发疫情进行调查和分析,为有效防控医院内发生的流感暴发疫情提供科学依据和经验借鉴.方法 采用现场流行病学调查方法,对某医院流感暴发疫情中病例进行个案调查,采集发热病例咽拭子标本,采用实时荧光PCR方法检测流感病毒核酸,应用MDCK细胞分离流感病毒,并采用全基因组测序方法对分离到的流感病毒进行序列分析.结果 2017年8月1日至7日,某医院呼吸科病区共报告发热病例30例,罹患率为28.58%.现场采集15例发热病例的咽拭子标本,经检测14例（94.3%）病例的标本为甲型H3N2亚型流感病毒核酸阳性;其中3例成功分离到甲型H3N2亚型流感病毒;对分离到的3株毒株进行基因测序分析,HA序列均属于3C.2a1分支,存在N171K、N121K突变.结论 此次疫情为北京市首起由3C.2a1分支甲型H3N2亚型流感病毒引起的医院内流感暴发疫情,提示医院也是流感疫情发生的重点场所.Objective To analyze the epidemiological characteristics of an outbreak of influenza A/H3N2 virus in a hospital, and to provide scientific basis to control and prevent outbreaks of influenza and other respiratory infectious diseases. Methods The field epidemiological methods were performed in the survey of this influenza outbreak in the hospital. Nucleic acid of influenza virus was detected by real-time fluorescence PCR, and MDCK cells was used to isolate influenza viruses. Sequence of influenza A （H3N2） viruses was detected by whole-genome sequencing. Results On August 1, 2017, 30 cases of fever were reported in the respiratory department of a hospital. The attack rate was 28.58 %. A total of 15 throat swab samples were obtained from fever patients. Of these, 14 （94.3%） were positive for influenza A （H3N2）, and three of them were successfully in isolation of influenza A /H3N2 virus. Gene sequencing analysis showed that the HA sequence belonged to the 3C. 2a1 clade, with N171K and N121K mutations. Conclusions The outbreak was caused by 3C. 2a1 clade influenza A/H3N2 in a hospital, and indicated that the hospitals were the important places of influenza outbreaks.

关 键 词：流感 暴发 H3N2 流行病学调查 

分 类 号：R181.81[医药卫生—流行病学] R511.7[医药卫生—公共卫生与预防医学]