摘要
目的探讨2009年杭州市甲型H1N1流感的流行规律、临床表现和病原学特征。方法对2009年杭州市13家流感监测哨点医院的每日门诊流感样病例和甲型H1N1流感确诊病例的流行病学进行分析。采用RT—PCR方法对咽拭子中血凝素（HA）基因进行扩增和测序，并用DNASTAR软件进行序列分析。全文数据采用SPSS12．0软件进行统计分析，率的比较采用χ^2检验。结果流感样病例监测显示，第28周之前，疫情处于平稳状态，之后全市流感样病例逐渐增多。第35周时达到高峰，全市流感样病例就诊比例为7．47％（5442／72859）。之后疫情回落，但到第41周时又再次回升，至第46周出现第二次高峰，全市流感样病例就诊比例达到11．32％（11034／97436）。第38周以前，杭州市人群中主要流行株是季节性H1N1型，其次有少量的乙型和季节性流感H1N1型，到第44周，甲型H1N1流感成为唯一的优势流行株，主要易感人群是11～25岁的青少年，以学生居多。序列分析显示，2009年杭州市甲型H1N1流感病毒株与北美株、中国其他地区的毒株以及疫苗株同源性达到99％，关键位点高度保守，但与季节性流感病毒株同源性只有70％。结论2009年杭州市流感疫情发展迅速，人群中流行的优势毒株为甲型流感H1N1型，易感人群为青少年，目前未发现变异株及高致病株，但仍需进一步监测。
Objective To investigate the epidemiological, clinical and etiological features of influenza/influenza A （H1N1 ） in Hangzhou city in 2009. Methods Epidemiological dala of patients with influenza-like illness or influenza A （H1N1） from 13 sentinel hospitals in Hangzhou （2009） were analyzed. Hemagglutinin （HA） genes of H1N1 subtype influenza virus were amplified by RT-PCR and the sequence analysis were performed by DNASTAR. SPSS 12.0 software was used for data processing and chi-square test was performed for difference comparison of rates. Results Epidemic curve for influenza-like illness was comparatively flat during the first 28 weeks of 2009, then the percentage of patients with influenza-like illness increased and climbed to the peak at 35th week （7.47% , 5 442/72 859）. This number declined in the following weeks but rose again at 41st week. At 46th week, a second peak appeared and the percentage of patients with influenza-like illness was 11.32% （ 11 034/97 436）. Virological surveillance showed that the circulation of influenza viruses before 38th week were mainly H3 N2, B and seasonal influenza virus H1N1, while from 44th week on, the pandemic H1N1 influenza was the only predominated strain. Main susceptible population in 2009 Hangzhou pandemic H1N1 influenza was people aged 11-25, and most of them were students. H1N1 strains of Hangzhou in 2009 were identical to strains in other parts of China, North American strains and vaccine candidate strain with 99% homology, but only 70% homology with seasonal influenza virus. Conclusions The 2009 influenza A （ H1N1 ） in Hangzhou has now entered a phase of rapid and sustained community transmission, susceptible populations are young adults. The predominated strain is the influenza A H1 N1 type with high affinity and low pathogenicity to humans and no important variation.
出处
《中华临床感染病杂志》
CAS
2010年第1期9-12,共4页
Chinese Journal of Clinical Infectious Diseases
关键词
流感
人
流感病毒A型
H1N1亚型
病原体
监测
流感样病例
Influenza, human
Influenza A virus, H1N1 subtype
Pathogens
Smveillance
Influenza-like illness
