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目的通过2009—2014年深圳市龙岗区中小学校甲型H1N1流感聚集性疫情流行传播特征分析,揭示疫情传播规律,为流感新病毒的科学防控提供理论依据。方法对龙岗区2009—2014年中小学校甲型H1N1流感聚集性疫情流行特征进行描述、曲线拟合和相关分析,比较疫情的即时传播速率、扩散方式和基本再生数R0。结果 6年间学校甲型H1N1疫情60起,病例数1 034例,平均罹患率10.50%,病例主要发生在小学人群(67.12%),聚集性疫情基本再生数R0在8~10之间,高于社会一般人群。2009年流行期,疫情高发,流行动力强,累积病例曲线和即时速率呈幂函数方式增长。罹患率与发病人数(r=-0.431,P<0.01)和持续时间(r=-0.386,P<0.01)均呈负相关,发病人数与疫情持续时间呈正相关(r=0.601,P<0.01),传播方式为突破班级限制向全校传播。一般防控措施效果不明显。2013年疫情小活跃期,疫情流行动力微弱,持续时间短,疫情为班内局部传播,报告后立即得到有效控制。结论 2009—2014年深圳市龙岗区中小学校甲型H1N1疫情流行动力高于社会一般人群,2009年甲型H1N1流感聚集性疫情流行动力强于2013年,主要与人群抗体水平有关,应根据疫情的流行动力情况制定策略和采取相应的防控措施。
OBJECTIVE: To analyze the epidemic spread of Influenza A (H1N1) in primary and secondary schools in Longgang District of Shenzhen City from 2009 to 2014 to reveal the epidemic transmission rules and provide a theoretical basis for the scientific prevention and control of new influenza viruses. Methods The prevalence of Influenza A (H1N1) epidemic in primary and secondary schools in Longgang District from 2009 to 2014 was described, curve fitted and related analysis. The instantaneous transmission rate, diffusion pattern and basic reproductive number R0 were compared. Results Six outbreaks of A (H1N1) were reported in schools in 6 years, with a total number of 1 034 cases and an average attack rate of 10.50%. The cases mainly occurred in primary school (67.12%), and the basic reproductive R0 was between 8 and 10, Social general population. During the epidemic in 2009, the outbreak was high, the epidemic was strong, and the cumulative case curve and instantaneous rate increased exponentially. The attack rate was negatively correlated with the number of patients (r = -0.431, P <0.01) and duration (r = -0.386, P <0.01) , The mode of dissemination is to break the class limit to spread throughout the school. General control measures effect is not obvious. In the small active period of 2013, the epidemic situation was weak with a short duration of endemicity and the epidemic was spread locally in the banquet. Immediately after the report, it was effectively controlled. Conclusion The prevalence of Influenza A (H1N1) in primary and secondary schools in Longgang District of Shenzhen City during 2009-2014 is higher than that of the general public. In 2009, the epidemic of Influenza A (H1N1) epidemic was stronger than that in 2013, which was mainly related to the antibody level of the population. Develop strategies and take appropriate prevention and control measures for the dynamics of the epidemic.