烟台市一起家庭聚集性人感染H7N9禽流感疫情调查及存活病例1年随访分析  

Epidemiological survey on a family clustering of human infection with avian influenza A ( H7N9) virus and one-year follow-up study on the survival case in Yantai City

作　　者：徐小雯[1] 姜梅[1] 孙振璐[1] 牟晓东[1] 刘涛[1] 刘靖宇[1] 

机构地区：[1]烟台市疾病预防控制中心,山东烟台264003

出　　处：《实用预防医学》2018年第2期212-215,共4页Practical Preventive Medicine

摘　　要：目的分析报告烟台市首起家庭聚集性人感染H7N9禽流感疫情,并了解人感染H7N9禽流感病例临床治疗后各项指标的恢复情况。方法对该起疫情进行流行病学调查,并对存活病例进行随访,对发病后1、3、6、12个月的复查结果进行比较、分析。结果病例1(父)有活禽接触史,救治无效死亡;病例2(子),与其父密切接触后发病,经治疗康复出院。存活病例发病1个月后复查血常规、肝功能和超声心动图检查正常;6个月后,自觉症状消失,肺部听诊无异常。发病1年内,心律异常持续存在,肺功能逐渐改善,肺部病灶逐渐吸收,仍留有条索状影及结节状高密度影。结论此疫情为人感染H7N9禽流感家庭聚集性疫情,感染途径可能为禽类暴露和有限的人传人。人感染H7N9禽流感病毒造成的肝脏和肺部损害有逐渐恢复的可能,心律失常可否恢复尚待进一步观察。Objective To analyze the epidemic situation of the first family cluster of two patients with avian influenza A { HTN9） infection in Yantai City, and to investigate the clinical consequence in the recovery phase. Methods A field investi- gation was conducted to collect epidemiological information of the two cases. The survival case was followed-up, and the reexami- nation results in the first, third, sixth and twelfth months after the onset of the disease were compared and analyzed. Results The index case （a father） , with a history of recent live poultry exposure, later died despite medical treatment. His son was thus recognized as the close contact survived. One month after the onset of the disease, the survival patient＇ s reexamination results of routine blood test, liver function test and ultrasonic cardiogram （UCG） were all normal. Six months after the onset of the disease, the subjective symptoms disappeared and no abnormal lung sound was heard on auscultation. In the first year of the onset, arrhyth- mia persisted and pulmonary functions gradually improved. Pulmonary lesions were absorbed gradually, but scanty amount of shad- ows of fibrotic streaks in lung still could be discovered. Conclusions It is the first family cluster of avian influenza A （H7N9） infection in Yantai City. Our findings indicate that the index case is likely to acquire virus infection from poultry or to transmit virus to his son. The liver and lung injury induced by H7N9 virus infection in human beings can be restored gradually, but the recovery of arrhythmia remains to be further observed.

关 键 词：甲型流感 禽流感 家庭聚集性 流行病学 随访研究 

分 类 号：R511.7[医药卫生—内科学]