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目的总结广州市甲型H1N1流感流行特点,为预防控制提供参考。方法从三间分布、本地病例与输入性病例特点、感染场所、暴发疫情特点、临床表现、流行病学史、发现方式等特征分析广州市2009年5~7月网络直报的173例实验室确诊病例。结果本地病例97例(56.1%),输入性病例76例(43.9%)。男性104例(60.1%),女性69例(39.9%)。年龄为6个月至71岁,中位数为18.4岁。本地病例感染场所主要为学校,占64.9%。输入性病例中60.5%为散发病例,而本地病例中23.7%为散发病例,以聚集性为主,两类病例流行形式差异有统计学意义(χ2=24.9,P<0.001)。临床表现以发热(≥37.5℃)(94.6%)、咳嗽(63.1%),咽痛(40.3%)为主。8.7%病例出现消化道症状。47.0%的病例与有明确类症状病人接触史。输入性病例发病至确诊时间比本地病例要短(t=2.791,P=0.006),发病至首次就诊时间间隔也比本地病例短(t=2.059,P=0.041)。输入性病例主要为出入境检验检疫发现(72.4%),本地病例主要为自行就诊发现(46.4%)。结论广州市仍处于甲型H1N1流感流行初期。部分甲型H1N1流感病例有消化道症状,提示消化道传播的可能性需要关注。
Objective To summarize the epidemic characteristics of Influenza A (H1N1) in Guangzhou and provide reference for prevention and control. Methods From the three distributions, the characteristics of local cases and imported cases, the infection sites, the characteristics of outbreaks, clinical manifestations, epidemiological history and findings, 173 laboratories in Guangzhou from May to July in 2009 were analyzed. Confirmed cases. Results There were 97 local cases (56.1%) and 76 imported cases (43.9%). There were 104 males (60.1%) and 69 females (39.9%). The age ranged from 6 months to 71 years with a median of 18.4 years. Local cases of infection mainly for schools, accounting for 64.9%. Among the imported cases, 60.5% were sporadic cases, while 23.7% of local cases were sporadic cases, mainly aggregates. There was a statistically significant difference between the two types of cases (χ2 = 24.9, P <0.001). Clinical manifestations of fever (≥ 37.5 ℃) (94.6%), cough (63.1%), sore throat (40.3%) based. 8.7% cases of gastrointestinal symptoms. 47.0% of cases and patients with clear symptoms of contact history. The incidence of imported cases was shorter than that of the local cases (t = 2.791, P = 0.006). The interval from onset to first visit was shorter than that of local cases (t = 2.059, P = 0.041). The imported cases were found mainly for entry-exit inspection and quarantine (72.4%). The local cases were found mainly for self-treatment (46.4%). Conclusion Guangzhou is still in the early stage of influenza A (H1N1) epidemic. Some cases of type A H1N1 influenza have gastrointestinal symptoms, suggesting the possibility of digestive tract spread needs attention.