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预防医学  2016, Vol. 28 Issue (8): 785-788,795    
  论著 本期目录 | 过刊浏览 | 高级检索 |
15例人感染H7N9禽流感病例分析
亓云鹏,顾伟玲,富小飞,谢亮,查亦薇,周晚玲
嘉兴市疾病预防控制中心,浙江嘉兴 314050
An analysis on the clinical and epidemiological characteristics of 15 cases of human infection with avian influenza A (H7N9) virus in Jiaxing City
QI Yun-peng,GU Wei-ling,FU Xiao-fei,XIE Liang,ZHA Yi-wei,ZHOU Wan-ling
The Center for Disease Control and Prevention of Jiaxing City,Jiaxing,Zhejiang,314050,China
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摘要 目的 分析嘉兴市人感染 H7N9禽流感15例确诊病例的临床与流行病学特征。方法 收集2013年4月—2015年5月嘉兴市报告的15例人感染H7N9禽流感病例的临床及流行病学调查资料,采集病例标本和疑似暴露场所外环境样本鉴定病毒亚型;采用描述性流行病学方法分析病例的三间分布及临床特征。结果 15例确诊病例中死亡11例,病死率为73.33%。所有病例均在冬春季节发病,9例年龄>60岁,男女比例为1.5∶1;其中10例病例来自农村地区,病例之间无明显的流行病学联系。15例病例的首发症状主要有发热、咳嗽、胸闷气急,胸部影像学检查均表现为磨玻璃影和(或)实变影,7例病例出现胸膜腔积液;其中12例患有慢性基础性疾病。11例病例因出现呼吸衰竭、肺栓塞、多脏器功能衰竭、心脑血管栓塞等一种或几种合并症而死亡。12例病例曾有活禽市场暴露史,其中9处活禽交易市场外环境中标本检出H7N9核酸阳性;252名密切接触者中仅有1人出现轻微流感样症状,所有密切接触者的咽拭子H7N9禽流感病毒核酸检测均为阴性。结论 嘉兴地区人感染H7N9禽流感疫情具有季节性,老年男性并伴有慢性基础性疾病者有可能是该病的易感人群,其感染来源与禽类暴露有关。
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亓云鹏
顾伟玲
富小飞
谢亮
查亦薇
周晚玲
关键词 人感染H7N9禽流感临床特征流行病学特征    
AbstractObjective To analyze the clinical and epidemiological characteristics of human avian influenza A (H7N9) epidemic in Jiaxing City,and to provide scientific basis for the control and prevention of the disease.Methods The epidemiological and clinical information of 15 cases of human infection with avian influenza A (H7N9) reported from April, 2013 to May, 2015 were collected.Sample of patients and external environmental samples of suspected exposure were collected and detected by real-time PCR.The epidemic distribution and clinical characteristics were analyzed.Results Fifteen cases of human infection with H7N9 were confirmed from April,2013 to May,2015, including 11 cases of death (77.33%). The confirmed cases mostly reported in winter and spring, and 9 confirmed cases were over 60 years, and male case proportion was higher than women (1.5∶1). Most of cases (66.67%) were sporadic and occurred in rural areas, but no epidemiological association was observed among the cases. Fever (100%), cough (66.67%), and wheezing and tightness in chest (33.33%) were common initial symptoms. The chest imaging examination of patients showed ground glass opacity and patchy consolidation, and 7 cases had simple pleural effusion. Twelve of confirmed cases had other chronic diseases.Eleven cases of death had appeared multiple medical comorbidities, such as respiratory failure (6/11), pulmonary embolism (4/11), multiple systemic organ failure (3/11), and heart cerebrovascular embolization (2/11). Twelve cases had been exposed to the live poultry markets where the positive rate of novel influenza A (H7N9) virus in environmental specimens was 7.69% (25/325). One of the 252 close contacts to confirmed cases appeared mild flu-like symptoms. No positive result related to novel influenza A (H7N9) virus nucleic acid was detected from each close contact's throat swabs.Conclusion Human infections with avian influenza A (H7N9) virus showed obvious seasonal distribution in Jiaxing. Elderly men, especially those with chronic diseases were the high risk people of human infection with H7N9 avian influenza.The infection might be associated with the exposure to live birds. Standard management of live poultry markets is the key measure in preventing and controlling H7N9 virus infection among population.
Key wordsHuman infection with avian influenza A (H7N9)    Clinical characteristic    Epidemiological characteristic
          出版日期: 2016-08-26
中图分类号:  R181.3  
基金资助:嘉兴市科技计划项目(2014AY21036-4
通信作者: 顾伟玲,E-mail:jxgwl@126.com   
作者简介: 亓云鹏,硕士,医师,主要从事急性传染病控制工作
引用本文:   
亓云鹏, 顾伟玲, 富小飞, 谢亮, 查亦薇, 周晚玲. 15例人感染H7N9禽流感病例分析[J]. 预防医学, 2016, 28(8): 785-788,795.
QI Yun-peng, GU Wei-ling, FU Xiao-fei, XIE Liang, ZHA Yi-wei, ZHOU Wan-ling. An analysis on the clinical and epidemiological characteristics of 15 cases of human infection with avian influenza A (H7N9) virus in Jiaxing City. Preventive Medicine, 2016, 28(8): 785-788,795.
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