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刘红慧, 邢学森, 占发先, 官旭华, 刘力, 刘琳琳, 黄丹钦, 刘漫, 吴杨. 湖北省人感染H7N9禽流感病例流行病学与临床特征分析[J]. 中国公共卫生, 2020, 36(2): 201-205. DOI: 10.11847/zgggws1120886
引用本文: 刘红慧, 邢学森, 占发先, 官旭华, 刘力, 刘琳琳, 黄丹钦, 刘漫, 吴杨. 湖北省人感染H7N9禽流感病例流行病学与临床特征分析[J]. 中国公共卫生, 2020, 36(2): 201-205. DOI: 10.11847/zgggws1120886
Hong-hui LIU, Xue-sen XING, Fa-xian ZHAN, . Epidemiological and clinical characteristics of human infections with H7N9 avian influenza virus in Hubei province, 2017[J]. Chinese Journal of Public Health, 2020, 36(2): 201-205. DOI: 10.11847/zgggws1120886
Citation: Hong-hui LIU, Xue-sen XING, Fa-xian ZHAN, . Epidemiological and clinical characteristics of human infections with H7N9 avian influenza virus in Hubei province, 2017[J]. Chinese Journal of Public Health, 2020, 36(2): 201-205. DOI: 10.11847/zgggws1120886

湖北省人感染H7N9禽流感病例流行病学与临床特征分析

Epidemiological and clinical characteristics of human infections with H7N9 avian influenza virus in Hubei province, 2017

  • 摘要:
      目的  描述湖北省人感染H7N9禽流感确诊病例的流行病学特征和临床特征。
      方法  搜集2017年“中国疾病预防控制信息系统”和“人感染H7N9禽流感信息管理系统”网络直报病例,结合现场流调和病例救治医疗机构收集等方式,分析病例临床和流行病学信息。
      结果  病例涉及全省9个市、州的20个县、区,有禽类相关接触史占96.67 %(29/30),禽类暴露方式排名前5位的为购买活禽(12/30)、宰杀活禽(8/30)、洗切生鲜禽肉(7/30)、饲养活禽(5/30)、经过活禽摊位(5/30)。死亡病例和治愈病例在性别(χ2 = 0.443,P = 0.314)、年龄(χ2 = 5.812,P = 0.214)、职业(χ2 = 3.529,P = 0.832)、发热情况(χ2 = 2.402,P = 0.493)、诊疗关键时间间隔、直接感染地(χ2 = 0.524,P = 0.377)、基础疾病史(χ2 = 0.023,P = 0.59)等方面均无统计学差异,但在首次就诊医疗机构差异上有统计学意义。有基础疾病的病例占60.00 %(18/30)。所有病例均有咳嗽、咳痰,66.67 %病例呼吸困难,60.00 %病例胸闷。所有病例在病程中均使用了奥司他韦抗病毒治疗,发病-首次使用奥司他韦的平均天数为(8.68 ± 5.73)d,首次使用奥司他韦到核酸转阴平均天数为(8.72 ± 4.41)d。
      结论  湖北省疫情全省高度散发,局部地区集中多发。首次就诊医疗机构对病例预后有一定影响。重症患者以发热、咳嗽、咳痰为首发症状,在疫情高发季节,对于有禽类接触史、临床表现不典型而呼吸衰竭进展快速的肺炎病例,应尽早使用抗病毒治疗。

     

    Abstract:
      Objective  To describe epidemiological characteristics and clinical features of human infection with H7N9 avian influenza virus in Hubei province in 2017.
      Methods  We extracted relevant data on all human infection cases (n = 30) with H7N9 avian influenza virus reported in Hubei province during 2017 from China Disease Prevention and Control Information System and Information Management System for Human H7N9 Avian Influenza Infection. Supplemental information were also collected by field study and from medical institutions involved in the diagnosis and treatment of the cases.
      Results  The cases distributed in 20 districts and counties in 9 municipalities across Hubei province. The history of exposure to poultry was confirmed in almost all the cases (96.67%, 29/30), including live poultry purchase, slaughter of live poultry, process of fresh poultry meat, poultry rearing, and passing by a site for live poultry sales which were ascertained in 12, 8, 7, 5, and 5 of the cases, respectively. There were no significant differences between the deaths and cured cases in gender (χ2 = 0.443, P = 0.314), age (χ2 = 5.812, P = 0.214), occupation (χ2 = 3.529, P = 0.832), fever symptom (χ2 = 2.402, P = 0.493), crucial time interval between diagnosis and treatment, location of infection (χ2 = 0.524, P = 0.377), and previous disease history (χ2 = 0.023, P = 0.59); but there was a significant difference in the type of medical institutions for the first time of seeking medical care. Of the cases, all had cough and phlegm; 66.67% had difficulty in breathing; and 60.00% had chest tightness. All the cases were treated with oseltamivir. The average interval between the onset of the disease and the time of first oseltamivir medication was 8.68 ± 5.73 days, and the average interval between the first medication of oseltamivir and negative conversion of virus nucleic acid was 8.72 ± 4.41 days.
      Conclusion  The epidemic of human infection with H7N9 avian influenza virus was highly sporadic as a whole but clustered in some regions in Hubei province in 2017. The type of medical institution providing first time medical care has certain impact on the prognosis of the human infection cases. The study results suggest that during epidemic seasons, antiviral therapy should be applied as early as possible to the infection cases with atypical clinical manifestations but confirmed history of exposure to poultry and pneumonia complicated by rapid progressive respiratory failure.

     

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