温州市2009-2016年儿童流感监测分析  

Analysis of children influenza surveillance results in Wenzhou from 2009 to 2014

作　　者：陈栋 孙宝昌[2] 张严峻[3] 杜垚强 虞成超[2] 吴矛矛 吴可可[2] 郑文力[2] Chen Dong;Sun Baochung;Zhang Yanjun;Du Yaoqiang;Yu Chengchao;Wu Maomao;Wu Keke;Zheng Wenli(The Sixth People＇s Hospital of Wenzhou, Wenzhou 325015, China;Wenzhou Center for Disease Control and Prevention, Wenzhou 325001, China;Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China;School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou 325035, Chin)

机构地区：[1]温州市第六人民医院,325015 [2]温州市疾病预防控制中心,325001 [3]浙江省疾病预防控制中心,杭州310051 [4]温州医科大学检验医学院生命科学学院,325035

出　　处：《中华实验和临床病毒学杂志》2018年第3期292-296,共5页Chinese Journal of Experimental and Clinical Virology

基　　金：浙江省医药卫生项目（2017KY634）;温州市科技计划项目（Y20170148,Y20140600）

摘　　要：目的对温州市2009—2016年儿童流感监测结果的病原学型别及流行病学特征进行分析，为儿童流感防控提供依据。方法通过对哨点医院的门急诊数和流感样病例（influenza-like illness，ILI）进行流行病学分析，对采集的儿童ILI标本进行核酸检测和病毒分离培养、测序，并对结果进行统计和分析。结果8年间哨点医院共监测门急诊病例10 577 089例，ILI共有337 896例，ILI病例就诊比例平均为3.19%。共检测儿童ILI标本4 046份，流感阳性511份，阳性率为12.63%，检出的流感型别中以乙型最多，H3N2次之；6个年龄组中，0～3岁组流感患者数最多，10～12岁组阳性率最高（35.03%）。甲、乙型流感HA分别有28和45个氨基酸序列突变，其中甲型391位和145位氨基酸发生多次突变；系统进化分析显示乙型不同年份毒株差异较大，且Yamagata进化为Y1和Y2两个分支。结论本市这8年间儿童流感主要以乙型、H3N2型、A（H1N1）型3个亚型交替流行为主，需重点加强学龄前儿童和中小学生的流感防治。ObjectiveTo analyze the etiology and epidemiological characteristics of influenza in Wenzhou from 2009 to 2014, so as to provide the scientific basis for control and prevention of influenza.MethodsThroat swab specimens of influenza like illness （ILI） were collected from national influenza surveillance sentinel hospitals for nucleic acid detection with real-time PCR and virus isolation, culture and sequencing, and the results were analyzed with statistical methods.ResultsDuring the 8 years, a total of 10 577 089 cases from outpatient and emergency department were monitored in sentinel hospitals. There were 337 896 ILI cases with an average ILI treatment rate of 3.19%. A total of 4 046 ILI samples were detected in children, 511 were positive for influenza, the positive rate was 12.63%. Among the detected influenza types, type B had the highest proportion, followed by H3N2. Among the 6 age groups, the number of flu patients was the highest in 0-3 years old group, the positive rate in 10-12 years old group was the highest （35.03%）. There were 28 and 45 amino acid sequence mutations of HA fragment in influenza A and B, respectively, which included multiple mutation of 391 and 145 amino acids. The phylogenetic analysis showed that the strains of type B were different in different years, and Yamagata evolved into Y1 and Y2 two branches.ConclusionsThe prevalence peaks of influenza in children occurred in winter and spring in Wenzhou city, accompanied by small peaks in summer. Three subtypes of serotypes B, H3N2 and A（H1N1） dominated alternatively in Wenzhou during the 8 years. We should focus on strengthening the prevention and control of influenza in preschool children and primary and secondary school students.

关 键 词：流感 监测 流感病毒 儿童 

分 类 号：R181.8[医药卫生—流行病学] R725.1[医药卫生—公共卫生与预防医学]