摘要
目的分析国内呼吸道腺病毒感染的流行病学特征,探讨其流行规律,为暴发疫情处置和临床早期诊断鉴别提供借鉴。方法从中国知网、万方数据以及Pub Med等数据库收集1997~2015年我国报道的呼吸道腺病毒流行及暴发文献,对呼吸道腺病毒感染流行时间、地区分布、人群分布、病毒型别和临床表现进行统计分析。结果呼吸道腺病毒病原分型分析显示,我国流行的呼吸道腺病毒包括1~7型、11型、14型、55型,其中以7型和3型为主,分别占暴发疫情病例的62.33%(599/961)和24.97%(240/961),占监测病例的36.79%(312/848)和53.18%(451/848)。暴发疫情病例以2004和2013年发病最多,分别占全部病例的41.12%(2212/5380)和16.49%(887/5380)。监测病例以2010和2011年发病最多,分别占全部病例的17.59%(297/1688)和17.77%(300/1688)。暴发疫情季节分布以冬春季为主。全国共有12个省(市)报道了呼吸道腺病毒暴发病例,3型呼吸道腺病毒以江苏最多,占58.33%(140/240),明显高于其他省(市)(P<0.01);7型呼吸道腺病毒以湖北最多,占67.41%(333/494),4型呼吸道腺病毒在广东报道1起,4例呼吸道腺病毒阳性。全国共有5个省(市)医院监测开展了呼吸道腺病毒的监测,其中以北京和江苏最多,占全部阳性病例的57.56%(971/1687)和32.42%(547/1687)。发病人群以儿童和入伍新兵为主要人群,占全部病例的73.97%(2907/3930)。腺病毒感染的主要临床表现为发热(63%~100%)、咽痛(31.9%~100%)、咽部充血(60%~100%)、咳嗽(5.88%~100%)。结论呼吸道腺病毒是引起我国学校和军队暴发疫情的主要病原之一。疾控机构有必要加强学校和军队呼吸道腺病毒的监测,分析总结不同类型呼吸道腺病毒的流行病学特征和传播扩散规律,积极开发相关疫苗,有效保护易感人群。
Objective To analyze the epidemiology of outbreaks and epidemic characteristics of respiratory diseases caused by human adenovirus in China so as to provide some data for its epidemic and outbreak control and clinical diagnosis. Methods Data on respiratory adenovirus outbreaks and surveillance from 1997 to 2015 was collected from Pub Med,China National Knowledge Infrastructure（ CNKI）,and Wanfang Databases. All the data was analyzed according to the descriptive epidemiology,including the time,area and population distribution. Clinical data and the serotypes of adenovirus were also analyzed. Results From 1997 to 2015,the epidemical serotypes of adenovirus included 1 to 7,11,14 and 55 in China,and the dominating serotypes were 7 and 3,which accounted for 62. 33%（ 599/961） and 24. 97%（ 240/961） of the total cases of outbreaks,and for 36. 79%（ 312/848） and 53. 18%（ 451/848） of the total cases of surveillance. The peaks of annual outbreaks were in 2004 and 2013,which made up 41. 12%（ 2212/5380） and 16. 49%（ 887/5380） of the total outbreak cases in this study. Most of the surveillance cases years occurred in 2010 and 2011,which accounted for 17. 59%（ 297/1688） and 17. 77%（ 300/1688） of the total cases of surveillance. The seasonal distribution of the outbreaks was characterized by the highest possibility in spring and winter. Outbreaks of respiratory adenovirus were reported by 12 provinces or municipalities. The number of reported outbreaks related to serotype 3 was the largest in Jiangsu Province,which made up 58. 33%（ 140/240） of the total. Most of the reported cases related to serotype 7 occurred in Hubei Province,which made up 67. 41%（ 333/494） of the total. Most of cases were found in Peking and Jiangsu,which accounted for 57. 56%（ 971/1687） and 32. 42%（ 547/1687） of the total positive cases respectively. The high-risk populations were children and new recruits,who accounted for 73. 97%（ 2907/3930） of the total. The clinical features of adenovirus infection were fever（ 63%-100%）,sore throat（ 31. 9%-100%）,pharyngeal hyperemia（ 60%-100%）and cough（ 5. 88%-100%）. Conclusion Human respiratory adenovirus has become one of the main pathogenic microorganisms that induce acute respiratory diseases in schools and in the military in China,so human adenovirus and related respiratory disease should be monitored in such populations. The epidemiological characteristics of different types of respiratory adenovirus and the patterns of spread should be analyzed in order to reduce morbidity and mortality.
作者
陈伟
王盛书
张文义
钱全
温亮
徐元勇
李青华
孙海龙
李申龙
王勇
CHEN Wei;WANG Sheng-shu;ZHANG Wen-yi;QIAN Quan;WEN Liang;XU Yuan-yong;LI Qing-Hua;SUN Hai-lortg;LI Sheng-lottg;WANG Yong(Institutes of Military Medicine, Academy of Military Sciences, Beijing 100850, China;Institute of Disease Control and Prevention of PLA, Beijingl00071, China)
出处
《军事医学》
CSCD
北大核心
2017年第10期814-821,共8页
Military Medical Sciences
基金
军队后勤科研重大项目(AWS16J020)
军队后勤科研重点项目(BWS14C051)
关键词
呼吸道腺病毒
暴发
监测
流行病学特征
respiratory adenovirus
outbreak
surveillance
epidemiological characteristic
