温州市2014-2017年人感染H7N9禽流感流行病学特征及危险因素分析  

Epidemiological characteristics and risk factors of human infection with H7N9 avian influenza in Wenzhou,2014-2017

作　　者：潘琼娇[1] 倪朝荣[1] 张晓铭[1] 孙宝昌[1] 李玲[1] PAN Qiong-jiao;NI Chao-rong;ZHANG Xiao-ming;SUN Bao-chang;LI Ling(Wenzhou Municipal Center for Disease Control and Prevention,Wenzhou,Zhejiang 325000,China)

机构地区：[1]温州市疾病预防控制中心,浙江温州325000

出　　处：《中国公共卫生管理》2020年第2期210-213,共4页Chinese Journal of Public Health Management

基　　金：温州市科技计划项目(Y20170667)。

摘　　要：目的分析温州市人感染H7N9禽流感流行特征及外环境禽流感病毒污染状况,为制定温州市人感染H7N9禽流感防控策略提供依据。方法收集温州市2014-2017年人感染H7N9确诊病例数据进行分析,临床与流行病学特征及外环境结果采用流行病学描述性分析方法,率的比较采用χ^2检验,病程比较采用秩和检验。结果温州市2014-2017年共确诊人感染H7N9禽流感病例31例,死亡14例,病死率为45.16%,年龄中位数为57岁,21例有基础性疾病,首发症状以发热为主。温州市2014-2017年人感染H7N9禽流感共有4个流行季,病例确诊集中在1-3月,占总确诊病例数的83.87%。31例病例中,有明确禽类暴露史27例。病例暴露农贸市场环境标本阳性率较暴露非农贸市场高,差异有统计学意义(χ^2=48.39,P<0.05)。病例暴露农贸市场环境标本阳性率较2014-2017年1-3月未发现病例农贸市场高,差异有统计学意义(χ^2=69.11,P<0.05)。第2和第4流行季,患者自发病至确诊的时间有所缩短(P<0.05)。结论高年龄并伴有基础疾病者是人感染H7N9禽流感的高危人群,温州市人群整体H7亚型阳性率不高,以散发为主。H7亚型禽流感病毒高度可能来自活禽交易农贸市场,活禽市场采取休市措施能显著控制疫情发展。Objective To analyze the epidemic characteristics of human infection and environmental contamination with H7 N9 avian influenza in Wenzhou,put forward the prevention and control strategy of human infection with H7 N9 avian influenza in Wenzhou.Methods The data of confirmed human infection with H7 N9 in Wenzhou from 2014 to 2017 were collected for analysis.The clinical and epidemiological characteristics and external environment results were analyzed by descriptive epidemiological analysis,the rate was compared by Chi-square test,and the disease course was compared by rank sum test.Results From 2014 to 2017,31 cases of H7 N9 avian influenza were diagnosed in Wenzhou,14 cases were death,the fatality rate was 45.16 %,and the median age was 57 years old.Twenty-one cases had basic diseases,the first symptoms were mainly fever.From 2014 to 2017,there were 4 epidemic seasons of human infection with H7 N9 in Wenzhou,and the confirmed cases were concentrated in January to March,accounting for 83.87 % of the total number of confirmed cases.Of the 31 cases,there were 27 cases with clear bird exposure history.The positive rate of environmental specimens in cases of exposure to farmers’ markets was higher than that of non-farmers’ markets,and the difference was statistically significant(χ^2=48.39,P<0.05).The positive rate of environmental specimens in cases exposed to farmers’ markets was higher than that of January and March of from2014 to2017.The difference was statistically significant(χ^2=69.11,P<0.05).In the second and fourth epidemic seasons,the time from the onset to the diagnosis of the patient was shortened,and the difference was statistically significant(P<0.05).Conclusion The people with high age and basic diseases are the high-risk group of human infection with H7 N9 avian influenza.The overall H7 positive population is not high,and the distribution is mainly.The trading of live poultry from the H7 subtype bird flu virus is highly likely.The adoption of closure measures in the live bird market can signific

关 键 词：人感染H7N9禽流感 临床特征 流行病学特征 外环境 

分 类 号：R511.7[医药卫生—内科学]