四川省首例人感染H7N9禽流感病例流行病学调查分析  

Epidemiological investigation of the first case of human infection with H7N9 avian influenza,Sichuan

作　　者：周丽君[1] 周兴余[1] 杨国富[2] 祝小平[1] 杨建红 刘伦光[1] 杨继红[2] 曾义学[1] 马超[2] 吕强[1] ZHOU Li-jun;ZHOU Xing-yu;YANG Guo-fu;ZHU Xiao-ping;YANG Jian-hong;LIU Lun-guang;YANG Ji-hong;ZENG Yi-xue;MA Chao;LV Qiang(Center for Disease Control and Prevention of Sichuan,Chengdu,Sichuan 610041,China)

机构地区：[1]四川省疾病预防控制中心,四川成都610041 [2]遂宁市疾病预防控制中心,四川遂宁629000 [3]遂宁市蓬溪县疾病预防控制中心,四川遂宁629100

出　　处：《现代预防医学》2018年第19期3496-3498,3503,共4页Modern Preventive Medicine

摘　　要：目的对四川省首例人感染H7N9禽流感病例流行病学资料进行分析,为类似疫情的防控提供参考。方法采用现场流行病学调查方法,对病例的禽类接触史、诊疗经历、密切接触者进行调查,对病例和相关的环境标本进行实验室检测。结果病例无明确的病死禽接触史,有活禽暴露史。仅病家厨房地面一份家禽粪便样流感病毒H9亚型核酸检测结果呈阳性,其余相关环境样标本检测结果均为阴性。病例为中年男性,具有肺部基础疾病史,临床症状有发热、咳嗽和全身肌肉酸痛。病例首次就诊医疗机构为乡村诊所。病例从发病到首次就诊、入院治疗、使用达菲和实验室确诊的时间间隔分别为5天、10天、13天和15天。结论该病例H7N9禽流感病毒感染来源尚不明确,患者的感染途径可能为禽-环境-人。应加强居家环境卫生、个人防护、做好活禽市场管理。提高基层医疗机构对流感病例识别和诊疗能力,早发现、早诊断、早治疗是降低禽流感病例死亡率的有效措施。Objective To analyze the epidemiological material of the first case of human infection with I-I7 N9 avian influenza in Sichuan, thus to provide a reference for prevention and control of the similar diseases. Methods We tested the samples collected from the patient and related environment by the method of field epidemiology to survey the poultry exposure history, diagnosis, treatment process and close contacts of the patient. Results There was no clear history of contacting with diseased or dead poultry, but he had a history of living poultry exposure. Only one poultry excrement sample was detected to be H9 positive which was collected from his family kitchen ground, and the rest of the specimens of relevant environmental samples test resuhs were negative. The patient was a middle - aged man who had a history of pulmonary disease. His clinical symptoms were fever, cough mad the whole - body muscle soreness. The first time he received the treatment was in a rural clinic. The time interval among the case from onset to first visit, admission to hospital, use Tamiflu and laboratory - confirmed were 5, 10, 13, 15 days, respectively. Conclusion The source of the H7N9 avian influenza virus infection is not clear. The patient＇s infection pathway may be poultry- environmenhuman. We should strengthen housekeeping, personal protection and market management of living poultry. Improving the level of diagnosis and treatment of the doctor in a basic medical institution, for early detection, diagnosis and treatment is an effective to measure to reduce the fatality rate of avian influenza case.

关 键 词：H7N9 禽流感 现场流行病学 

分 类 号：R181.23[医药卫生—流行病学]