3例人感染H7N9禽流感病毒病例的流行病学特征及其对策分析

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目的:分析2014年度苏州市姑苏区外环境监测的数据与该区2014年12月—2015年1月间确诊报告的3例人感染H7N9病毒病例的流行病学特征,以便进一步了解外环境与人感染H7N9病毒发病之间关联,为采取切实可行防控人禽流感措施提供依据。方法:对苏州市姑苏区所有存在禽类交易的农贸市场进行外环境采样,对确诊病例与病例的密切接触者进行个案调查并采样送检,分析其对流行病学特征。结果:3例病例发病时间都与去过农贸市场的外环境监测阳性一致,其病例呈高度散发,病例之间无流行病学关联,发病时间均为冬季,均有农贸市场暴露史;将病例采取隔离治疗,对密切接触者进行医学观察、疫点终末消毒;建议政府对检出阳性标本的市场暂停交易活禽,未检出阳性的市场应加强管理,落实定期休市与消毒的制度,控制疫情扩散。结论:具有活禽交易的农贸市场实施采样,其阳性与3例具有农贸市场暴露史的人感染高H7N9禽流感病毒病例的发病存在关联,暂未发现人传人的证据;早期发现和救治患者是提高患者预后的关键,应加强人感染H7N9禽流感病毒疫情的监测,并根据《苏州市活禽交易管理办法》相关规定,向政府建议对检出阳性标本的市场暂停交易活禽,未检出阳性的市场应加强管理,落实“四分开”和定期休市与消毒的制度。 OBJECTIVE: To analyze the epidemiological characteristics of three cases of human H7N9 virus infection in 2014 in Gusu District of Suzhou City and the confirmed diagnosis of the district from December 2014 to January 2015 in the district in order to further understand the relationship between the external environment and people The relationship between the incidence of H7N9 infection and provide a basis for practical measures to prevent and control human bird flu. Methods: The external environment was sampled in all farmers markets with poultry transactions in Gusu District of Suzhou City. Individuals who had close contact with the confirmed cases and cases were investigated by case and sampled for inspection, and their epidemiological characteristics were analyzed. Results: The onset time of the three cases were all consistent with the external environmental monitoring of the farmer’s market. The cases were highly distributed, no epidemiological correlation was found between the cases, and the onset time was winter. There was a history of exposure to the farmer’s market. Adopt isolation treatment to conduct medical observation on close contact persons and final disinfection of epidemic areas; Propose that the government suspend the trading of live poultry in the market where the positive specimens are detected, and the market that has not been tested positive shall strengthen the management and implement the system of regular closure and disinfection, Control the spread of the epidemic. Conclusion: The sample of farmers’ market with live poultry transaction was sampled. The positive correlation was found between the cases of human H7N9 avian influenza virus infection with the history of exposure to three farmers markets. No evidence of human transmission was found yet. The early detection and treatment of patients was Improve the prognosis of patients with key, should strengthen the human infection of H7N9 avian influenza virus outbreak monitoring, and in accordance with the “Suzhou City, Livestock and Poultry Trading Management Measures,” the relevant provisions of the government recommended positive samples were detected in the market to stop trading live poultry, undetected Positive market should strengthen management, implementation of “four separate ” and the system of regular closure and disinfection.
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