论文部分内容阅读
目的了解福建省H7N9禽流感病例的特征,为进一步防控提供参考。方法从人感染H7N9禽流感信息管理系统收集福建省2013~2014年人感染H7N9禽流感疫情资料,用描述性流行病学方法分析其流行特征。2014年福建省活禽市场的外环境标本数据来源于应急监测资料。资料统计分析使用Epi info软件。结果 2013、2014年福建省共确诊22例实验室确诊人感染H7N9病例,其中死亡6例,病死率27.27%。86.36%(19/22)的病例为男性,死亡6例,病死率31.58%,13.64%(3/22)的病例为女性,无女性死亡病例。发病时间主要集中在2013年的4月和2014年的1月,2013、2014年病死率分别为20.00%、29.41%。77.78%(7/9)的设区市、15.91%(14/88)的县(市、区)报告病例,主要集中泉州、福州和厦门(占总数的82%),未发现聚集性疫情和二代病例。病例的年龄为3~81岁,中位年龄52岁,下四分位数P25~上四分位数P75:30~60岁,死亡病例的年龄为27~81岁,中位年龄55岁,P25~P75范围:30~81岁。54.55%(12/22)的病例有去过活禽市场。77.78%(21/27)县(市、区)、38.61%(39/101)活禽市场、25.36%(157/619)标本应急监测禽流感阳性。68.18%(15/22)的病例有基础性疾病。13.64%(3/22)的病例通过ILI监测发现,均为轻症病例。86.36%(19/22)通过不明原因肺炎监测发现,均为重症病例。病例390名密切接触者中在医学观察期限内出现发热等症状有15人,检测咽拭子H7N9均为阴性。结论福建省人感染H7N9禽流感病例以散发为主,未出现聚集性疫情和二代病例,冬春高发。男性病死率高于女性,年龄大的病例构成比大。病例的主要暴露史是去过活禽市场,活禽市场外环境污染严重。通过ILI监测发现的病例均为轻症病例,通过不明原因肺炎监测发现的病例均为重症病例。在发生人感染H7N9禽流感确诊病例的县(区)内,应当在病例确诊后开展为期2周的强化监测。
Objective To understand the characteristics of H7N9 bird flu cases in Fujian Province and provide reference for further prevention and control. Methods The epidemic situation of H7N9 bird flu in Fujian Province from 2013 to 2014 was collected from human infected H7N9 avian influenza information management system, and its epidemiological characteristics were analyzed by descriptive epidemiology. The data of external environment specimens of the live poultry market in Fujian Province in 2014 come from emergency monitoring data. Statistical analysis of data using Epi info software. Results In 2013 and 2014, a total of 22 laboratory confirmed cases of human H7N9 infection were confirmed in Fujian Province, among which 6 died and the case fatality rate was 27.27%. 86.36% (19/22) of the cases were male, 6 died, the case fatality rate was 31.58%, and 13.64% (3/22) cases were female. There were no female deaths. The onset time mainly concentrated in April 2013 and January 2014, and the case fatality rates in 2013 and 2014 were 20.00% and 29.41% respectively. 77.78% (7/9) of districts and 15.91% (14/88) of the counties (cities and districts) reported cases, mainly focusing on Quanzhou, Fuzhou and Xiamen (82% of the total), and no cluster epidemic was found Second-generation cases. The age of the patients ranged from 3 to 81 years with a median age of 52 years. The lower quartile P25 ~ upper quartile P75: 30 ~ 60 years old. The deaths were from 27 to 81 years old, with a median age of 55 years. P25 ~ P75 range: 30 ~ 81 years old. 54.55% (12/22) cases have been to live poultry market. 77.78% (21/27) counties (cities and districts), 38.61% (39/101) live poultry markets and 25.36% (157/619) specimens were in urgent need of emergency surveillance of positive bird flu. 68.18% (15/22) of the cases had underlying diseases. 13.64% (3/22) cases were detected by ILI and all were mild cases. 86.36% (19/22) were found to be severe cases by pneumonia surveillance of unexplained causes. Among the 390 patients who were closely contacted, 15 cases were found to have fever during the medical observation period, and throat swab H7N9 was negative. Conclusions The cases of H7N9 bird flu in Fujian Province are predominantly sporadic, with no cluster epidemic and second-generation cases, with high prevalence in winter and spring. The mortality rate of males is higher than that of females, and the proportion of older patients is larger. The main case history of exposure to live poultry market, live poultry market outside the serious environmental pollution. The cases detected by ILI monitoring were all mild cases. Cases found by pneumonia monitoring by unknown causes were all severe cases. In the counties (districts) where human confirmed cases of H7N9 bird flu occur, intensive surveillance should be conducted for two weeks after the diagnosis of the case.