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目的通过对2013年香港确诊的1例人感染H7N9禽流感患者的流行病学调查,为人感染H7N9禽流感的科学防控提供依据。方法采用流行病学调查方法,调查病例的发病经过、可能的感染来源、传播途径及暴露因素等,医学观察患者的密切接触者,同时对外环境进行采样检测。结果确诊1例人感染H7N9禽流感病毒,经救治无效后死亡。患者有禽类及市场暴露史。6名密切接触者中未出现呼吸道症状,经采样检测也均排除H7N9禽流感。通过扩大监测流感样病例(ILI)2 057例以及严重急性呼吸道感染病例(SARI)62例,均未发现人感染H7N9禽流感病例。采集患周边市场禽类档口的17份环境标本进行检测,结果为5份鸡笼标本H9流感病毒核酸阳性,H7及H5均为阴性。结论患者的感染因素可能为家庭中加工禽类及暴露于活禽市场,应加强活禽市场管理,加大宣传力度,减少人感染H7N9流感病毒的风险。
OBJECTIVE: To provide a basis for scientific prevention and control of human H7N9 avian influenza by analyzing the epidemiological investigation of 1 human being infected with H7N9 bird flu in Hong Kong in 2013. Methods Epidemiological survey methods were used to investigate the pathogenesis of the disease, the possible sources of infection, the route of transmission and exposure factors. The patients were observed closely by medical observation, and the external environment was sampled and tested at the same time. Results confirmed 1 human H7N9 bird flu virus, died after treatment ineffective. Patients have history of bird and market exposure. No respiratory symptoms were found in 6 close contacts and H7N9 bird flu was also excluded by sampling and testing. No case of human H7N9 bird flu was detected by expanding 2,057 influenza-like illness cases (ILI) and 62 cases of severe acute respiratory infections (SARI). Seventeen environmental samples from poultry stalls in the peripheral markets were collected and tested. The results showed that 5 samples of chicken H9 influenza virus were positive for nucleic acid, and H7 and H5 were both negative. Conclusions The infection factors of the patients may be the processing of poultry in the family and exposure to the live poultry market. The management of the live poultry market should be strengthened to increase publicity and reduce the risk of human H7N9 influenza virus infection.