上海市2014-2020年流感发病强度的变化情况  

Changes in epidemic intensity of influenza during 2014-2020 in Shanghai

作　　者：游倩 姜晨彦[2] 郑雅旭[2] 吴寰宇[2] 潘浩[2] 袁政安[2] 张娟娟 余宏杰[1] You Qian;Jiang Chenyan;Zheng Yaxu;Wu Huanyu;Pan Hao;Yuan Zheng'an;Zhang Juanjuan;Yu Hongjie(Department of Epidemiology,Key Laboratory of Public Health Safety of Ministry of Education,School of Public Health,Fudan University,Shanghai 200032,China;Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China)

机构地区：[1]复旦大学公共卫生学院流行病学教研室/公共卫生安全教育部重点实验室,上海200032 [2]上海市疾病预防控制中心,上海200336

出　　处：《中华流行病学杂志》2023年第8期1224-1230,共7页Chinese Journal of Epidemiology

基　　金：上海市市级科技重大专项(ZD2021CY001);上海市青年科技启明星计划(22QA1402300)。

摘　　要：目的评估上海市2014-2020年流感监测网络的运行情况以及流感发病强度的变化。方法基于上海市2014年1月1日至2020年12月31日的流感监测数据,对哨点医院流感样病例(ILI)缺报漏报和ILI标本采集情况进行评价,计算ILI就诊百分比(ILI%)、流感病毒检出阳性率和流感发病率,利用季节性自回归移动平均模型构建“反事实”情况下2020年流感发病强度的基线,以定量估计上海市2020年流感发病强度的相对变化。结果2020年上海市ILI缺报漏报情况评价得分和ILI标本采集情况评价得分<5分的医院占比分别为9.68%和21.05%。上海市2014-2019年和2020年的ILI%分别为1.51%(95%CI:1.50%~1.51%)和2.31%(95%CI:2.30%~2.32%),流感病毒检出阳性率分别为24.27%(95%CI:24.02%~24.51%)和7.15%(95%CI:6.78%~7.54%),流感发病率分别为3.66‰(95%CI:3.62‰~3.70‰)和1.65‰(95%CI:1.57‰~1.74‰)。上海市2020年的ILI%升高了45.25%,流感病毒检出阳性率和流感发病率分别降低了78.45%和51.80%。结论2020年上海市流感监测网络的运行情况发生改变,ILI%有所升高,流感病毒检出阳性率和流感发病率均有所降低,流感监测质量的改变是一个潜在的影响因素,未来仍需进一步加强流感监测的质量控制。Objective To evaluate the performance of the influenza surveillance network and compare the epidemic intensity of influenza during 2014-2020 in Shanghai.Methods Based on the weekly reports of influenza-like illness(ILI)and laboratory-confirmed influenza cases from January 1,2014 to December 31,2020.This study first evaluated the data reporting and specimen collection of ILI cases for each sentinel hospital,and then calculated the percentage of ILI(ILI%),the proportion of specimens tested positive for influenza,and the incidence of influenza among all ILI outpatient and emergency visits to measure the epidemic intensity of influenza.Finally,seasonal autoregressive integrated moving average(ARIMA)model was applied to quantify the changes in epidemic intensity of influenza in 2020.Results The proportion of influenza surveillance sentinel hospitals with a score of less than 5 in the evaluation of ILI data reporting and samples collection were 9.68%and 21.05%in 2020 in Shanghai,respectively.ILI%was estimated to be 1.51%(95%CI:1.50%-1.51%)and 2.31%(95%CI:2.30%-2.32%),respectively for 2014-2019 and 2020;the proportion of specimens tested positive was 24.27%(95%CI:24.02%-24.51%)and 7.15%(95%CI:6.78%-7.54%),respectively;and the incidence of influenza was 3.66‰(95%CI:3.62‰-3.70‰)and 1.65‰(95%CI:1.57‰-1.74‰),respectively.ARIMA model showed that ILI%was increased by 45.25%in 2020 in Shanghai,and the proportion of specimens tested positive and the incidence of influenza were reduced by 78.45%and 51.80%,respectively.Conclusions In 2020,the performance of influenza surveillance system has changed,ILI%has increased,the proportion of specimens tested positive and the incidence of influenza has decreased in Shanghai.The change in the quality of influenza surveillance is also a potential factor affecting the epidemic intensity of influenza.In the future,the quality control of influenza surveillance network still needs to be further strengthened.

关 键 词：流感 自回归移动平均模型 发病强度 非药物性干预措施 

分 类 号：R511.7[医药卫生—内科学]