移动流行区间法在宁波市冬春季流感流行强度预警中应用  

Application of moving epidemic method in early warning of influenza incidence intensity in winter-spring season in Ningbo city

作　　者：丁克琴[1] 谷少华[1] 劳旭影[1] 陈奕[1] 易波[1] 许国章[1] DING Keqin;GU Shaohua;LAO Xuying;CHEN Yi;YI Bo;XU Guozhang(Department of Infectious Disease Control and Prevention,Ningbo Municipal Center for Disease Control and Prevention,Ningbo 315010,China)

机构地区：[1]宁波市疾病预防控制中心,宁波315010

出　　处：《中国公共卫生》2023年第7期817-822,共6页Chinese Journal of Public Health

基　　金：宁波市公益类科技计划项目(2021S162);宁波市“科技创新2025”重大专项(2021Z021);宁波市市级医疗卫生品牌学科(PPXK2018-10)。

摘　　要：目的探索移动流行区间法(MEM)在浙江省宁波市冬春季流行性感冒(流感)流行强度预警中的应用,为采取相应的干预措施提供参考依据。方法收集2013年1月—2022年5月宁波市2家国家级流感哨点医院的流感监测数据,最终选择2013年1月—2019年12月的冬春季流感病毒检测阳性率建立MEM模型,对宁波市2019—2020年流感流行季(2019年第40周至2020年第20周)开始、结束以及流行强度进行分析,并与实际流行情况进行比较,分析MEM模型的应用效果。结果宁波市2013—2022年流感病毒分为甲型H1N1、甲型H3N2和乙型(以Victoria株和Yamagata株为主),分别占24.59%、37.03%和38.38%;本研究建立的MEM模型参数δ为2.7,灵敏度为87.97%,特异度为87.68%,约登指数为0.76,拟合优度最高;经MEM模型拟合,2019—2020年流感季流行开始阈值为22.76%,流行结束阈值为25.05%,中流行强度阈值为43.18%,高流行强度阈值为63.22%,极高流行强度阈值为74.83%;2019年第40周至第48周为流行前期,在2019年第49周流感突破流行开始阈值进入低流行阶段,从第51周开始达到中等流行强度一直持续到2020年第3周,2020年第4周后再降为低流行强度;2020年第7周以后处于流行后阶段,第10周流感流行结束;2019—2020年与2013—2019年比较,流感流行季的开始时间提前了1周,但流行结束时间提前了3周。结论MEM模型在宁波市冬春季流感流行早期识别和流行强度预警中的应用效果较好。Objective To explore the application of moving epidemic method(MEM)in early warning of influenza incidence intensity in winter-spring season in Ningbo city and to provide a reference for developing effective intervention measures.Methods Influenza surveillance data for the period of January 2013-May 2022 were collected from 2 national influenza sentinel hospitals in Ningbo city,Zhejiang province and a part of the data on positive rate of influenza virus detection among the registered cases in winter-spring seasons from January 2013 to December 2019 were extracted to establish a MEM model.The constructed MEM model was adopted to analyze the beginning,the end and incidence intensity of seasonal influenza epidemic during 2019-2020(40th week,2019-20th week,2020)in Ningbo city;the model analysis results were compared with actual situation of the epidemic.Results For the virus-positive cases in the city during the 2013-2022,the proportions of isolated viral strains were 24.59%for influenza A(H1N1),37.03%for influenza A(H3N2),and 38.38%for influenza B(mainly Victoria and Yamagata strain),respectively.The established MEM model showed a better goodness-of-fit,with the parameterδof 2.7,the sensitivity of 87.97%,the specificity of 87.68%,and the Yoden index of 0.76.Based on the fitting results of the established MEM model,the thresholds of viruspositive rate were 22.76%and 25.05%for identifying the onset and the end of the influenza epidemic and the thresholds were 43.18%,63.22%,and 74.83%for indicating a moderate-,high-,extremely high-intensity of the influenza epidemic during 2019-2020 influenza season.With the established MEM threshold estimations,the trajectory of the influenza could described as following:pre-epidemic stage from 40th week to 48th week of 2019,onset/low-intensity stage from 49th week of 2019,moderate-intensity stage from 51th week of 2019 to third week of 2020,subsequent low-intensity stage from 4th week of 2020,late stage from 7th week of 2020,and the end of the epidemic by the 10th week of 2020.Compa

关 键 词：流行性感冒(流感) 流行强度 预警 移动流行区间法(MEM) 应用 

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