2023-2024监测年度山东省流感流行特征及流感病毒基因特征分析  

Analysis on epidemiological characteristics of influenza and genetic characteristics of influenza virus in 2023-2024 surveillance year in Shandong Province

作　　者：何玉洁 孙林[1] 宋绍霞[1] 张淑 吴巨龙[1] 董阳 李忠[1] 王显军[1] 寇增强[1] 刘倜[1,3,4] He Yujie;Sun Lin;Song Shaoxia;Zhang Shu;Wu Julong;Dong Yang;Li Zhong;Wang Xianjun;Kou Zengqiang;Liu Ti(Shandong Provincial Center for Disease Control and Prevention/Shandong Institute of Preventive Medicine/Shandong Provincial Key Laboratory of Intelligent Monitoring,Early Warning and Prevention of Infectious Diseases,Jinan 250014,China;Jinan Second Maternal and Child Health Care Center,Jinan 271100,China;School of Public Health and Health Management,Shandong First Medical University,Jinan 250117,China;School of Public Health,Shandong Second Medical University,Weifang 261053,China)

机构地区：[1]山东省疾病预防控制中心/山东省预防医学研究院/山东省传染病智慧化监测预警和防控重点实验室,济南250014 [2]济南市第二妇幼保健院,济南271100 [3]山东第一医科大学公共卫生与健康管理学院,济南250117 [4]山东第二医科大学公共卫生学院,潍坊261053

出　　处：《中华流行病学杂志》2025年第3期430-439,共10页Chinese Journal of Epidemiology

基　　金：山东省自然科学基金(ZR2021MH372);山东省疾病预防控制中心青年创新基金(QC-2022-02);山东省公共卫生学会科研项目(SGWXH202301);山东省医药卫生科技项目青年项目(202312051021)。

摘　　要：目的分析2023-2024监测年度山东省流感流行特征、流感病毒病原学特征及基因特征。方法收集2023-2024监测年度山东省哨点医院流感样病例监测数据,并进行描述性分析;从分离的病毒中挑选血凝滴度≥8的毒株进行抗原性分析、耐药监测、基因测序及进化分析。结果2023-2024监测年度山东省流感病毒阳性率为8.51%(23663/277995),以5~14岁年龄组的阳性率最高(15.78%,6073/38478),按周次以2023年第49周的阳性率最高(35.86%,2264/6313)。流感病毒优势株为A(H3N2)亚型毒株,抗原性分析和进化分析均显示,A(H1N1)pdm09亚型毒株和B(Victoria)系毒株与2023-2024监测年度疫苗株匹配效果较好、进化距离较近。A(H3N2)亚型毒株与2023-2024监测年度疫苗株匹配效果不好且进化距离较远,与2024-2025监测年度疫苗株进化距离较近。耐药监测发现,1株A(H1N1)pdm09亚型毒株对奥司他韦敏感性高度降低且发生了神经氨酸酶氨基酸H275Y位点变异。结论2023-2024监测年度山东省流感病毒流行高峰主要集中在冬、春季,5~14岁年龄组为重点防控对象,优势毒株为A(H3N2)亚型毒株,该亚型毒株与2023-2024监测年度疫苗株匹配效果不好,在耐药监测工作中发现1株A(H1N1)pdm09耐药株。后续防控工作应强化对流感病毒的流行特征、基因变异和耐药特征的监测力度,及时了解流感病毒的流行趋势和变异规律,并及时发现流感病毒耐药株,推进流感疫苗接种,提高流感防控能力。Objective To analyze the epidemiological,etiological and genetic characteristics of influenza virus in Shandong Province during 2023-2024.Methods The surveillance data of influenza-like illness(ILI)in sentinel hospitals in Shandong from 2023 to 2024 were collected and analyzed.The isolated influenza strains with hemagglutination titers≥8 were selected for antigenicity analysis,drug susceptibility test,gene sequencing and evolutionary analysis.Results From 2023 to 2024,the positive rate of influenza virus in Shandong was 8.51%(23663/277995),the highest positive rate was in the age group of 5-14 years(15.78%,6073/38478),and the highest positive rate was in the 49th week(35.86%,2264/6313).Both antigenicity analysis and evolutionary analysis showed that the A(H1N1)pdm09 subtype and B(Victoria)strain had good matching effect and close evolutionary distance with the 2023-2024 surveillance year vaccine strain.The A(H3N2)subtype strain did not have a high matching effect with the 2023-2024 vaccine strain and had a long evolutionary distance,but had a close evolutionary distance with the 2024-2025 vaccine strain.Drug susceptibility test showed that oseltamivir sensitivity of influenza A(H1N1)pdm09 strain decreased greatly,and the amino acid site mutation of neuraminidase was H275Y.Conclusions In the 2023-2024 surveillance year,the peak of influenza virus epidemic in Shandong was mainly occurred in winter and spring,and the age group of 5-14 years was the focus of prevention and control.The dominant strain was subtype A(H3N2),which had poor matching effect with the vaccine strain in the 2023-2024 surveillance year.One A(H1N1)pdm09 resistant strain was found in the drug resistance monitoring work.Follow-up prevention and control work should be strengthen the surveillance for the epidemiological characteristics,genetic variation and drug resistance of influenza viruses,timely understand the epidemic trend and mutation of influenza viruses,timely discover drug-resistant strains of influenza viruses,promote influenza vaccina

关 键 词：流感 流行特征 基因特征 监测 

分 类 号：R51[医药卫生—内科学]