杭州市96例人感染H7N9禽流感病例临床流行病学特征分析

doi:10.11853/j.issn.1003.8280.2019.06.024

摘要/Abstract

摘要： 目的分析杭州市2013-2018年人感染H7N9禽流感病例临床流行病学特征，为H7N9禽流感的治疗和预防提供科学依据。方法收集2013-2018年杭州市人感染H7N9禽流感病例临床资料，使用EpiData 3.1数据库录入数据，应用SPSS 16.0软件进行统计学分析，对不同组别间病死率的比较采用χ²检验。结果 2013-2018年杭州市累计报告确诊人感染H7N9禽流感病例96例，死亡33例，病死率为34.38%。杭州市共经历5个流行季，5个流行季的疫情病死率差异无统计学意义（χ²=6.131，P=0.190）；城区病例47例，死亡14例，病死率为29.79%，农村病例49例，死亡19例，病死率为38.78%，两组病死率差异无统计学意义（χ²=0.859，P=0.354）；男性病例64例，死亡21例，病死率为32.81%，女性32例，死亡12例，病死率为37.50%，两组病死率差异无统计学意义（χ²=0.208，P=0.649）；60岁以下年龄组病例49例，死亡10例，病死率为20.41%，60岁及以上年龄组病例为47例，死亡23例，病死率为48.94%，两组病死率差异有统计学意义（χ²=8.655，P=0.003）；不同职业组间病死率差异无统计学意义（χ²=5.728，P=0.126）；有基础疾病的病例52例，死亡25例，病死率为48.08%，无基础疾病的病例43例，死亡7例，病死率为16.28%，差异有统计学意义（χ²=10.654，P=0.001）。结论高年龄组和有基础疾病的人群感染H7N9禽流感病例病死率较高，是禽流感防治的重点人群。

关键词: H7N9禽流感, 流行病学, 分析

Abstract: Objective To investigate the epidemiological and clinical features of avian influenza A (H7N9) virus infection in humans in Hangzhou, China, and to provide a scientific basis for the prevention and treatment of avian influenza A (H7N9) virus infection. Methods Related clinical data were collected from the patients with avian influenza A (H7N9) virus infection in Hangzhou from 2013 to 2018. EpiData 3.1 database was used for data entry, and SPSS 16.0 softuare was used for statistical analysis. The chi-square test was used for comparison of mortality rate between groups. Results A total of 96 confirmed cases of avian influenza A (H7N9) virus infection were reported in Hangzhou from 2013 to 2018, among whom 33 patients died, resulting in a mortality rate of 34.38%. There were 5 waves of H7N9 epidemics in Hangzhou, and there was no significant difference in mortality rate between the five waves (χ²=6.131, P=0.190). There were 47 patients in the urban area with 14 deaths (29.79%) and 49 patients in the rural area with 19 deaths (38.78%), and there was no significant difference in mortality rate between the two groups (χ²=0.859, P=0.354). There were 64 male patients with 21 deaths (32.81%) and 32 female patients with 12 deaths (37.50%), and there was no significant difference in mortality rate between the two groups (χ²=0.208, P=0.649). There were 49 patients in the age <60 years group with 10 deaths (20.41%) and 47 in the age ≥ 60 years group with 23 deaths (48.94%), and there was a significant difference in mortality rate between the two groups (χ²=8.655, P=0.003). There was no significant difference in mortality rate between the groups with different occupations (χ²=5.728, P=0.126). A total of 52 patients had underlying diseases, among whom 25 died, with a mortality rate of 48.08%; 43 patients had no underlying diseases, among whom 7 died, with a mortality rate of 16.28%; there was a significant difference in mortality rate between the two groups (χ²=10.654, P=0.001). Conclusion Patients with avian influenza A (H7N9) virus infection who have an older age and underlying diseases tend to have a high mortality rate and thus they are the key population for the prevention and treatment of avian influenza.

Key words: Avian influenza (H7N9), Epidemiology, Analysis

中图分类号:

任晓宾, 孙昼, 王婧, 杨旭辉, 刘牧文, 考庆君, 朱雷. 杭州市96例人感染H7N9禽流感病例临床流行病学特征分析[J]. 中国媒介生物学及控制杂志, 2019, 30(6): 696-698.

REN Xiao-bin, SUN Zhou, WANG Jing, YANG Xu-hui, LIU Mu-wen, KAO Qing-jun, ZHU Lei. Epidemiological and clinical features of avian influenza A (H7N9) virus infection in humans in Hangzhou, China: an analysis of 96 cases[J]. Chines Journal of Vector Biology and Control, 2019, 30(6): 696-698.

参考文献

[1] Gao RB,Cao B,Hu YW,et al. Human infection with a novel avian-origin influenza A (H7N9) virus[J]. N Engl J Med,2013,368(20):1888-1897. DOI:10.1056/NEJMoa1304459.
[2] 丁华,谢立,考庆君,等. 杭州市首例人感染H7N9禽流感病例调查[J]. 中华预防医学杂志,2013,47(12):1155-1156. DOI:10.3760/cma.j.issn.0253-9624.2013.12.019.
[3] 韩迪迪,韩春霞,李璐钰,等. 中国2013-2017年人感染H7N9禽流感的流行病学特征[J]. 中华流行病学杂志,2018,39(1):44-46. DOI:10.3760/cma.j.issn.0254-6450.2018.01.009.
[4] 曹明华,侯赛,龚磊,等. 安徽省人感染H7N9禽流感病例临床流行病学分析[J]. 现代预防医学,2018,45(2):201-203.
[5] 张敏,李伟权. 广东省人感染H7N9禽流感流行特征与防控对策[J]. 公共卫生与预防医学,2015,26(6):5-9.
[6] 许可,鲍倡俊. 人感染H7N9禽流感流行病学研究进展[J]. 江苏预防医学,2015,26(1):43-47. DOI:10.13668/j.issn.1006-9070.2015.01.015.
[7] Ji H,Gu Q,Chen LL,et al. Epidemiological and clinical characteristics and risk factors for death of patients with avian influenza A H7N9 virus infection from Jiangsu province,Eastern China[J]. PLoS One,2014,9(3):e89581. DOI:10.1371/journal.pone.0089581.
[8] 刘刚,张义,张怡,等. 陕西省首例人感染H7N9禽流感病例及聚集性疫情调查分析[J]. 中国人兽共患病学报,2018,34(4):376-381. DOI:10.3969/j.issn.1002-2694.2018.00.048.
[9] 朱蒙曼,郑俐敏,谢昀,等. 江西上饶一起人感染H7N9禽流感家庭聚集性疫情调查[J]. 中国公共卫生,2018,34(3):435-438. DOI:10.11847/zgggws1114749.
[10] 曾志笠,朱蒙曼,袁辉,等. 江西泰和县一起人感染H7N9禽流感家庭聚集性疫情调查[J]. 中华疾病控制杂志,2017,21(4):428-430. DOI:10.16462/j.cnki.zhjbkz.2017.04.026.
[11] Qi X,Qian YH,Bao CJ,et al. Probable person to person transmission of novel avian influenza A (H7N9) virus in Eastern China,2013:epidemiological investigation[J]. BMJ,2013,347:f4752. DOI:10.1136/bmj.f4752.
[12] Chen Y,Liang WF,Yang SG,et al. Human infections with the emerging avian influenza A H7N9 virus from wet market poultry:clinical analysis and characterisation of viral genome[J]. Lancet,2013,381(9881):1916-1925. DOI:10.1016/S0140-6736(13)60903-4.
[13] 吕华坤,龚震宇,孙继民,等. 浙江省人感染H7N9禽流感疫情特征与活禽市场休市的影响分析[J]. 疾病监测,2014,29(9):700-703. DOI:10.3784/j.issn.1003-9961.2014.09.008.
[14] Wu P,Jiang H,Wu JT,et al. Poultry market closures and human infection with influenza A(H7N9) virus,China,2013-14[J]. Emerg Infect Dis,2014,20(11):1891-1894. DOI:10.3201/eid2011.140556.

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