贵州省2014-2018年人感染H7N9禽流感病例流行病学调查分析  

Epidemic characteristics of human infection with avian influenza A(H7N9)virus cases in Guizhou,2014-2018

作　　者：黄艳[1] 唐光鹏[1] 王定明[1] 余春[1] 雷明玉[1] 孙洁[1] 陶忠发 HUANG Yan;TANG Guang-peng;WANG Ding-ming;YU Chun;LEI Ming-yu;SUN Jie;TAO Zhong-fa(Guizhou Province Center for Disease Control and Prevention,Guiyang,Guizhou 550004,China)

机构地区：[1]贵州省疾病预防控制中心,贵州贵阳550004

出　　处：《现代预防医学》2020年第7期1164-1166,1191,共4页Modern Preventive Medicine

摘　　要：目的了解贵州省H7N9禽流感病例的特征,为进一步防控提供参考。方法收集贵州省2014-2018年人感染H7N9禽流感临床及流行病学疫情资料,用描述性流行病学方法分析其流行特征。结果2014-2018年贵州省共确诊21例人感染H7N9人禽流感病例,死亡11例,病死率52.3%。以男性、中老年、农民为主,61.9%的病例发生在黔东南和黔南地区,2017年病例数占总病例数的80.9%,未发现聚集性疫情和二代病例。病例发现以不明原因肺炎监测发现为主,从暴露到发病、发病到首诊、发病到确诊、发病到抗病毒药物使用及发病到死亡的时间中位数分别为5天、3天、7天、7天和14天;有无基础性疾病的病死率差异无统计学意义(χ^2=0.38,P=0.54),后期病例病死率低于前期(χ^2=4.24,P=0.04)。19例本地病例均有明确的活禽或活禽市场相关环境接触史,其中94.7%的活禽市场或活禽相关场所均检出H7核酸阳性,平均阳性率为32.3%(1.34%~82%),全面长期关闭活禽市场后疫情得到有效控制。结论接触活禽或活禽市场环境是感染的主要因素;加强活禽市场外环境监测,规范化管理及长期关闭活禽市场,可有效预警和控制疫情;加强基层医疗机构救治水平可有效降低病死率。Objective To understand the characteristics of human infection with avian influenza A(H7 N9)virus cases reported in Guizhou Province,so as to provide reference for further prevention and control.Methods The clinical and epidemiological data of human infection with avian influenza A(H7 N9)virus in Guizhou Province from 2014 to 2018 were collected.Descriptive epidemiology was used to analyze the epidemiological characteristics.Results A total of 21 cases of human infection with avian influenza A(H7 N9)virus were diagnosed in Guizhou Province from 2014 to 2018,11 cases were died with the fatality rate of 52.3%.The cases mainly were male,middle aged and farmers,mainly concentrated in southeastern and southern in Guizhou Province(accounted for 61.9%),cases reported in 2017 accounted for 80.9%of the total cases,and the aggregated epidemic and secondary cases were not detected.Cases were mainly detected through surveillance of unexplained pneumonia cases.The median of time from exposure to morbidity,morbidity to first diagnosis,morbidity to diagnosis,onset to antiviral drug use and onset to death respectively were 5 days,3 days,7 days,7 days and 14 days,respectively.There was no difference between cases whether suffer from basic diseases and fatality rate(χ^2=0.38,P=0.54),the fatality rate of later stage was lower than early stage(χ^2=4.24,P=0.04).94.7%of the local cases had a clear history of exposure to live poultry or live poultry markets environmental,and H7 nucleic acid positive was detected in external environment which had epidemiological related,the average positive rate of external environmental surveillance was 32.3%(1.34%~82.2%),the epidemic situation was effectively controlled after the live poultry markets was closed long-termly.Conclusion Exposure to live poultry or live poultry markets are the main factors of infection.Strengthening external environmental surveillance of live poultry markets,standardizing management and closing the live poultry markets long-termly can effectively warn and control the oc

关 键 词：人感染H7N9禽流感 流行病学 监测 

分 类 号：R511.7[医药卫生—内科学] R181.3[医药卫生—临床医学]