摘要
目的通过对重症社区获得性肺炎(severe community-acquired pneumonia,SCAP)病例进行甲型流感/禽流感病原学检测,及时发现流感和人间禽流感疫情,为流感和禽流感疫情预测预警提供科学依据。方法以惠州市最大三甲综合医院为哨点医院采集病例标本,采用实时荧光定量PCR方法,开展SCAP病例的甲型流感和禽流感病原体监测。结果2013年1月-2017年12月,共完成652例SCAP病例样品的采集和检测,SCAP病例主要为5岁以下和60岁以上人群,病例时间分布高峰期为1-3和12月份,与甲流阳性率一致;652例SCAP病例中,有123份甲型流感病例,主要亚型为甲型H1N1,共85份(69.11%);5岁以下和60岁以上年龄组甲流阳性率最高,各年龄组阳性率差异有统计学意义(χ~2=24.379,P=0.002);共检出9例禽流感病例,年龄主要分布在50~60岁,女性人数多于男性,发病时间大部分集中在2月份;首例H7N9病例病毒序列与国内同期病毒有高度同源。结论 2013-2017年惠州市SCAP流行有明显的季节性,5岁以下儿童和60岁以上的老年人是SCAP病例的主要人群,甲型流感阳性率也最高,在流感流行季节对以上人群进行流感疫苗接种,可有效预防由于流感导致的SCAP;开展SCAP病例的甲型流感和禽流感病原体监测项目,可以及时发现高致病性人禽流感病例,对禽流感的早期预警和疫情管理有很好的指导意义。
Objective To analyze the epidemic situation of influenza A and avian influenza through monitoring the pathogens of cases of severe community-acquired pneumonia（ SCAP）,and to provide a scientific basis for prediction and control of influenza and avian influenza. Methods SCAP samples were collected from a sentinel hospital,the largest comprehensive hospital,in Huizhou City. The real-time fluorescence quantitative PCR method was used to detect the pathogens of influenza A and avian influenza in SCAP cases. Results A total of 652 SCAP samples were collected and detected from January 2013 to December 2017.The SCAP cases were mainly children under 5 years old and the elderly aged 60 years and above. The epidemic of the SCAP cases peaked in January-March and December,which were consistent with the positive rate of influenza A. Among the 652 SCAP cases,123（ 18.86%） cases were positive for influenza A virus,and influenza subtype A（ H1 N1） pdm09 was the most common,amounting to 85（ 69.11%） cases. The positive rate of influenza A was found to be the highest in the age groups of under 5 years and 60 years and above,and there were statistically significant differences in the positive rate among different age groups（ χ^2= 24.379,P =0.002）. Totally 9 cases of avian influenza were detected,and most cases occurred in people aged 50-60 years. Female cases were more than male ones,and most of the cases occurred in February. The virus sequence of the first H7 N9 case was highly homologous to the domestic virus in the same period. Conclusions The prevalence of SCAP in Huizhou City during 2013-2017 showed an obvious seasonality. Most of the SCAP cases were children under 5 years old and the elderly aged 60 years and above,and the positive rate of influenza A was also the highest among these groups. Implementing vaccination among the above-mentioned groups in the flu season can effectively prevent SCAP induced by influenza,and conducting surveillance of pathogens of influenza A and avian influenza in SCAP cases can detect cases of highly pathogenic avian influenza virus infection in time,which has a good guiding significance for early warning and management of avian influenza.
作者
刘燕
方巧云
曾健君
杨剑英
徐励琴
骆玉萍
LIU Yan;FANG Qiao-yun;ZENG Jian-jun;YANG Jian-ying;XU Li-qin;LUO Yu-ping(Huizhou Municipal Center for Disease Control and Prevention,Huizhou,Guangdong 516003,China)
出处
《实用预防医学》
CAS
2018年第8期922-925,共4页
Practical Preventive Medicine
基金
惠州市科技计划项目(20160810)
关键词
重症社区获得性肺炎
甲型流感
禽流感
severe community-acquired pneumonia
influenza A
avian influenza
