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目的调查诸暨市一起人感染H7N9禽流感聚集性疫情的感染来源和传播途径,为防制人感染H7N9禽流感提供依据。方法对2例人感染H7N9禽流感确诊病例及其密切接触者、可疑暴露场所进行现场调查,采集病例及密切接触者咽拭子标本、可疑暴露场所外环境标本,采用实时荧光定量PCR检测H7N9禽流感病毒核酸。结果病例A于2015年1月23日发病,2月4日确诊为人感染H7N9禽流感病例。调查发现A有活禽市场暴露史和家禽接触史,采集病例A发病前常去的活禽交易市场外环境标本10份,其中1份禽类笼具表面擦拭物标本检出H7N9禽流感病毒核酸阳性。病例B为病例A的胞兄,于2月7日发病,2月8日确诊为人感染H7N9禽流感病例,有过搀扶病例A、接触其擦拭痰液的餐巾纸等高危暴露行为,也有活禽市场暴露史和家禽暴露史。2例病例病情危重,均死亡。结论此疫情为一起人感染H7N9禽流感聚集性疫情,2例病例感染最可能的来源为活禽市场暴露,但也不能排除病例B与病例A密切接触感染的可能。
Objective To investigate the sources of infection and transmission of a human infection of H7N9 bird flu in Zhuji City to provide a basis for preventing human infection with H7N9 bird flu. Methods Two cases of confirmed human cases of H7N9 avian influenza and their close contact with suspected contacts were investigated on site. Samples of throat swabs and suspected environmental exposure were collected from the cases and close contacts. Real-time fluorescent quantitative PCR was used to detect H7N9 Flu virus nucleic acid. Results Case A developed on January 23, 2015 and was confirmed as a human case of H7N9 bird flu on February 4. The survey found that there was a live poultry market exposure history and history of poultry exposure. A total of 10 environmental samples were collected from the live poultry market frequented before the onset of case A. One of the poultry samples with surface wipes showed positive H7N9 avian influenza virus nucleic acid . Case B was the brother of Case A, with onset on February 7, confirmed cases of human H7N9 bird flu on February 8, high-risk exposure such as supporting Case A, napkins touching its wiping sputum, live poultry market Exposure history and history of poultry exposure. Two cases were critically ill and both died. Conclusions This outbreak was a co-infected H7N9 bird flu epidemic. The most likely source of infection in 2 cases was exposure to the live poultry market. However, case B could not be excluded from the possibility of close contact with case A.