2014-2023年度浙江省杭州市流感样病例流行特征及趋势分析  

Epidemiological characteristics and incidence trend of influenza like illness in Hangzhou,Zhejiang,2014-2023

作　　者：王哲 王乙 陶明勇 金新叶 段晓健 王婧[2] 刘牧文[3] 杨旭辉[4] 孙昼[5] Wang Zhe;Wang Yi;Tao Mingyong;Jin Xinye;Duan Xiaojian;Wang Jing;Liu Muwen;Yang Xuhui;Sun Zhou(Department of Public Health Emergency,Hangzhou Center for Disease Control and Prevention(Hangzhou Health Supervision Institution),Hangzhou 310021,Zhejiang,China;Institute of Infectious Disease Control and Prevention,Hangzhou Center for Disease Control and Prevention(Hangzhou Health Supervision Institution),Hangzhou 310021,Zhejiang,China;Department of Health Education,Hangzhou Center for Disease Control and Prevention(Hangzhou Health Supervision Institution),Hangzhou 310021,Zhejiang,China;Department of Health Hazards Surveillance,Hangzhou Center for Disease Control and Prevention(Hangzhou Health Supervision Institution),Hangzhou 310021,Zhejiang,China;Department of AIDS/STDs Control and Prevention,Hangzhou Center for Disease Control and Prevention(Hangzhou Health Supervision Institution),Hangzhou 310021,Zhejiang,China)

机构地区：[1]杭州市疾病预防控制中心(杭州市卫生监督所)公共卫生应急办,浙江杭州310021 [2]杭州市疾病预防控制中心(杭州市卫生监督所)传染病防制所,浙江杭州310021 [3]杭州市疾病预防控制中心(杭州市卫生监督所)健康教育所,浙江杭州310021 [4]杭州市疾病预防控制中心(杭州市卫生监督所)健康危害因素监测所,浙江杭州310021 [5]杭州市疾病预防控制中心(杭州市卫生监督所)艾滋病性病防制所,浙江杭州310021

出　　处：《疾病监测》2025年第2期176-183,共8页Disease Surveillance

基　　金：杭州市卫生科技计划(No.A20220843);杭州市农业与社会发展科研引导项目(No.20220919Y058)。

摘　　要：目的掌握2014—2023年度浙江省杭州市流感样病例(ILI)的流行特征和趋势,为今后流行性感冒(流感)防控提供科学依据和理论基础。方法收集整理2014—2023年度杭州市哨点医院流感监测数据,采用描述统计方法描述流行特征;构建以年度为自变量、ILI占门急诊病例总数的百分比(ILI%)为因变量的分段点线性Joinpoint回归模型,探索ILI流行趋势。结果2014—2023年度杭州市15家流感哨点医院累计报告ILI 1788669例,ILI%为2.85%,15岁以下年龄组ILI占比最高(53.11%),各年度城区ILI%(3.38%)均高于郊区地区(2.26%)(P<0.001)。10年间在2家国家级哨点医院中共采集ILI咽拭子样本23471份,其中流感病毒阳性样本4346份,病原学阳性率(PR)为18.52%,以甲型H3N2、乙型Victoria系和甲型H1N1(pdm09)为主,2019年后未监测到乙型Yamagata系病毒。流感流行主要集中在冬春季,部分年份存在夏季小高峰;ILI%和PR有较强的相关性,时间交叉相关性分析结果显示,相较于PR,ILI%能提前1周反映高峰。Joinpoint回归分析结果显示,10年间ILI%无转折点,总体呈现上升趋势,平均年度变化百分比(AAPC)=8.48%(P=0.007);城区和郊区的ILI%均呈上升趋势,但变化不平衡(P<0.001),城区变化幅度(AAPC=3.58%,P=0.268)小于郊区地区(AAPC=19.07%,P=0.001),城区与郊区均无转折点。结论杭州市ILI以冬春季流行为主,部分年度存在夏季小高峰,流行强度较北方地区强,但略低于纬度更低的南方地区,15岁以下儿童是防控的重点人群;ILI%可以提前1周反映流行高峰,在10年间ILI%呈现逐年增高的趋势,郊区地区快速上升,逐步接近城区水平,需引起关注。Objective To understand the epidemiological characteristics and incidence trend of influenza-like illness(ILI)in Hangzhou,Zhejiang province,from 2014 to 2023,and provide evidence for the prevention and control of influenza in the future.Methods The local incidence data of ILI from 2014 to 2023 were collected from sentinel hospitals in Hangzhou,and descriptive statistical methods were used to analyze the epidemiological characteristics of ILI.A segmented-point linear Joinpoint regression model with the year as independent variable and the proportion of ILI cases in total outpatient visits as dependent variable was constructed to explore the incidence trend of ILI.Results From 2014 to 2023,a total of 1788669 ILI cases were reported cumulatively by 15 influenza sentinel hospitals in Hangzhou,and the proportion of ILI cases was 2.85%in total outpatient visits.This proportion was highest in age group under 15 years(53.11%),and the annual proportion in urban area(3.38%)was higher than that in suburban area(2.26%)(P<0.001).During this period,a total of 23471 throat swabs were collected from ILI cases in two sentinel hospitals at national level,in which 4346 were positive for influenza viruses,and the etiological positive rate was 18.52%.The main types were influenza A(H3N2)virus,influenza B virus Victoria lineage,and influenza A(H1N1)pdm09 virus,and no influenza B virus Yamagata lineage was detected after 2019.Influenza mainly occurred in winter and spring,with sub-peaks in summer in some years.There was a strong correlation between the ILI case proportion and the positive rate,and the time cross-correlation analysis indicated that the ILI case proportion predicted the incidence peak 1 week earlier compared with the positive rate.The Joinpoint regression analysis showed that overall ILI case proportion showed an upward trend without obvious change during this period,the average annual percent change(AAPC)=8.48%(P=0.007).Both urban and suburban ILI case proportions showed upward trend,but the changes were unbalanced(P<0.

关 键 词：流感样病例 流行特征 趋势分析 Joinpoint回归 

分 类 号：R211[医药卫生—中医学] R184R511.7