2009-2015年甘肃省酒泉市流行性感冒病原学监测结果分析

目的 了解甘肃省酒泉市2009-2015年流行性感冒（流感）病原学特征和流行动态，为流感防控工作提供科学决策。方法 对2009-2015年度国家流感监测哨点医院采集流感样病例咽拭子标本，采用实时荧光定量聚合酶链反应进行流感病毒核酸检测及其型别和亚型鉴定，对部分核酸检测阳性样品进行病毒培养、分离和鉴定。结果 2009-2015年共检测流感样病例标本3332例，流感病毒核酸阳性率为21.54%，其中各型流感病毒核酸阳性数及构成比分别是甲型H1N1 277例（38.58%），甲型H3N2 224例（31.20%）和乙型217例（30.22%）。7年间流感病毒检出率依次为28.60%、25.63%、18.25%、21.58%、18.23%、19.44%和20.60%，各年度阳性率差异有统计学意义（2=25.51，P=0.000）；0~、1~、5~、15~、25~和60~岁年龄组的阳性率依次为6.90%、15.85%、29.07%、23.96%、21.43%和14.29%，5~岁年龄组阳性率最高，各年龄组流感病毒核酸阳性率差异有统计学意义（2=74.51，P=0.000）。流感病毒核酸阳性病例主要集中在10月至次年3月，病毒核酸检测阳性病例占总阳性病例的91.50%；分离到流感病毒105株，其中69株甲型H1N1，14株甲型H3N2，10株乙型B/Victoria，12株乙型B/Yamagata。结论 甘肃省酒泉市流感流行每年有1个高峰期，主要发生在冬春季，5~岁儿童感染率最高，流行毒株在不同时间呈现型别优势且存在年度交替流行的特点。流感防控措施的重点时间在冬春季，建议加强5~岁组儿童的流感疫苗接种。

Etiological surveillance for influenza in Jiuquan,Gansu, 2009-2015

Objective To understand the etiological and epidemiological characteristics of influenza in Jiuquan, Gansu province, from 2009 to 2015, and provide evidence for the prevention and control of influenza. Methods Throat swabs were collected from influenza like illness (ILI) cases in the sentinel hospitals included in national influenza surveillance network for influenza virus nucleic acid detection by real-time RT-PCR and virus isolation, culture and identification were conducted for some positive samples. Results During the seven years, 3332 throat swabs from ILI patients were tested for influenza virus nucleic acid, in which 718 were positive (21.54%), including 277 A/H1N1 virus positive samples (38.58%), 224 A/H3N2 viruspositive samples (31.20%) and 217 B virus positive samples (30.22%), and the annual positive rate of influenza virus were 28.60%, 25.63%, 18.25%, 21.58%, 18.23%, 19.44% and 20.60% respectively from 2009 to 2015. The differences were significant (2=25.51, P=0.000) and the positive rate in age group 5-years was highest (29.07%) among the six age groups, and the positive rates were 6.90%, 15.85%, 29.07, 23.96%, 21.43%and 14.29% respectively in age groups 0-years, 1-years, 5-years, 15-years, 25-years and 60 years, the differences were significant(2=74.51, P=0.000).The positive influenza virus nucleic acid samples were mainly detected from October to March, accounting for 91.50%. A total of 105 influenza virus strains were isolated and identified, including 69 A/H1N1strains, 14 A/H3N2 strains, 10 B/Victoria lineage strains and 12 B/Yamagata lineage strains. Conclusion There was one influenza incidence peak in each year in Jiuquan, which was during winter-spring. The infection was highest in 5-years old children and the predominant influenza virus differed with season and year. Therefore, it is necessary to strengthen influenza vaccination in children aged 5-years before annual influenza season.