深圳市不同人群和鸡群感染禽流感病毒H9N2亚型状况研究

目的分析禽流感病毒H9N2亚型毒株在深圳市不同人群和鸡群中的感染状况。方法采用常规的鸡胚双腔法分离流感病毒；采用红细胞凝集抑制试验（H1）和中和试验测定流感病毒抗体。结果从深圳市农贸市场300只鸡只样本中分离到27株H9N2亚型流感病毒，其抗体阳性率为7％，但未能从人群中分离到H9N2亚型流感病毒。人群血清中其抗体阳性率与职业高度相关，与鸡只密切接触的人群明显高于非密切接触的人群。结论禽流感病毒H9N2亚型对人群和鸡群均易感，可通过近距离的密切接触传播；推测人所感染的H9N2可能主要来源于鸡只等家禽。     

2013年广州市禽流感职业暴露人群及市场环境禽流感病毒H7N9监测分析

目的了解广州市禽流感职业暴露人群中禽流感病毒H7N9、H9、H5亚型隐性感染状况以及禽类市场环境中H7N9病毒污染状况。方法采集从事家禽养殖、宰杀、贩卖等职业暴露人群以及H7N9疫情专项调查人群血清标本,用红细胞凝集抑制试验（HI）检测H7N9、H9、H5亚型抗体;用实时荧光定量PCR方法对禽类市场环境标本进行H7N9禽流感病毒核酸检测。结果2013年采集职业暴露人群常规监测血清394份,广州某市场首次检出H7N9禽流感病毒后采集密接从业人员专项血清259份,H7、H5检测抗体均为阴性,H9抗体阳性血清分别为23份（5.83％）和7份（2.70％）;6264份市场环境标本中共检出流感A阳性标本204份,其中H7N9亚型阳性5份（0.07％）、H5亚型阳性13份（0.20％）、H9亚型阳性80份（1.27％）、A未分型106份（1.69％）。结论广州市禽流感职业暴露人群在2013年市场首次检出H7N9禽流感病毒前后尚未发现H7N9隐性感染者,广州市禽类市场环境中禽流感病毒亚型仍以H9等低致病性亚型为主,但不排除今后H7N9亚型增多的可能。     

2010年绵阳市H5N1禽流感职业暴露人群流行病学和血清学调查分析

目的了解绵阳市职业人群H5N1禽流感病毒感染状况,为人禽流感防治提供基础资料和科学依据。方法对全市9个县市区的200人职业人群发放问卷,对工作环境、个人防护措施等进行调查,同时采集其血清查H5N1禽流感病毒抗体。结果我市职业人群在通风好、干净整洁的环境中工作的占50%以上;37%的职业人群不懂得如何处理禽类污物。清理污物后59%的人不懂得保护环境。个人防护方面,能做到每次接触禽类均穿戴防护设施的人群占20%～32%。而近半年来职业人群手足部位皮肤曾明显破损者占31.65%。200人血清中未查见H5N1禽流感病毒抗体。结论我市禽类中暂时不存在H5N1禽流感病毒,相关部门应做好禽流感病毒禽间和人间监测,加强对职业暴露人群的健康教育,使其做好自身防护,减少感染机会。     

2011-2012年广州市禽类经营环境职业人群禽流感监测分析

目的了解2011-2012年广州市禽类经营环境中的职业人群H5及H9亚型禽流感的感染情况,为防治人禽流感提供科学的依据。方法采集广州市12个区从事饲养、销售和屠宰家禽的职业人群的静脉血572份,一般人群血清648份,通过血凝抑制实验进行抗体检测,采集禽类经营外环境标本415份,通过PCR进行核酸检测。结果职业人群中H5N1抗体阳性率为0.52%,一般人群H5N1抗体均为阴性,职业外环境中H5亚型标本阳性率4.10%;H9亚型阳性率1.69%。结论广州市禽类经营环境职业人群存在一定的隐性感染,职业环境中存在H5、H9亚型禽流感病毒的污染,具有感染高致病性禽流感的风险,应加强职业人群的禽流感监测,防止销售病死禽及提供充足个人防护用品,加强健康教育。     

不同职业暴露人群感染H5N1禽流感病毒风险性分析

目的了解长沙地区不同类型禽类职业暴露人群高致病性禽流感H5N1亚型病毒的抗体分布状况,分析不同职业暴露人群H5N1感染的风险性。方法采集菜市场家禽屠宰零售人员、大型家禽饲养企业工人和农村个体家禽散养人员的血清标本,用单放射免疫扩散溶血技术（SRH）检测H5N1抗体。结果市场零售人员、农村个体家禽散养人员、企业饲养人员H5N1感染率分别为25%、1%和1.92%,男性从业人员H5N1抗体阳性率为10%,女性为23.88%。结论市场零售人员感染H5N1风险性远高于农村散养人员和企业饲养人员,不同职业人员中女性H5N1抗体阳性率高于男性从业人员。     

广西健康青年H9、H6亚型禽流感病毒血清抗体调查

目的调查广西医科大学2007年新生中H9、H6亚型流感病毒的抗体水平，以了解广西健康青年是否已受到H9、H6亚型禽流感病毒感染。方法广西医科大学2007级新生血清168份，通过HI实验进行抗体检测。结果以HI抗体滴度≥1：10为流感病毒抗体阳性，H9亚型抗体阳性率13．69％；有两份H6亚型抗体阳性。结论广西健康青年人群已受到禽流感H9亚型病毒株的感染，H6亚型也可能感染了人群。     

2014年江苏省江阴市职业暴露人群禽流感血清学调查

目的了解江阴市职业暴露人群H5、H7、H9亚型禽流感病毒的感染状况,为制定人感染禽流感防控措施提供科学依据。方法采集监测人群血清,用马血球红细胞凝集抑制试验检测血清中的H5N1、H7N9、H9N2亚型禽流感病毒HI抗体,数据用Excel软件进行统计分析。结果共调查职业暴露人群80人,血清学结果显示14份标本H7N9和27份H9N2亚型禽流感病毒中和抗体阳性,总阳性率为45. 00%。职业暴露人群和对照组人群HI抗体效价阳性率差异有统计学意义(χ2=10. 98,P <0. 05)。问卷调查显示人群年龄偏大、文化水平偏低、流感疫苗接种率为0. 00%,防护意识较差。结论职业暴露人群存在H7N9和H9N2隐性感染现象,应加强健康教育,提高防护意识,同时加强职业人群和外环境监测,降低禽流感感染风险。     

潮汕地区健康青年H9、H6、H5亚型甲型流感病毒血清抗体调查

目的：调查潮汕地区健康青年中H9、H6、H5三种甲型流感病毒亚型的隐性感染情况，以期了解上述三种禽类甲型流感病毒亚型是否能够或已经从禽类直接或间接传染给人。方法：潮汕地区健康青年血清946份，通过HI实验进行抗体检测。结果：H9亚型抗体阳性率达37．2％；同时发现有三份血清存在H5抗体；未见H6亚型抗体的存在。结论：H9亚型在健康青年中的隐性感染率非常高；H5亚型抗体的存在也应值得注意。     

宁夏职业暴露人群血清学和环境高致病性禽流感监测分析

目的了解宁夏职业暴露人群高致病性H5N1禽流感病毒的感染状况和环境高致病性禽流感病毒的分布情况,为其预防控制策略的制定提供科学依据。方法根据《2011年全国职业暴露人群血清学和环境高致病性禽流感监测方案》的要求,采用马红细胞血凝抑制试验检测职业暴露人群H5N1血凝素抗体;采用Real-timePCR对环境标本进行H5、H7、H9禽流感病毒核酸检测。结果职业暴露人群400人份血清H5N1抗体均为阴性;环境标本302份禽流感病毒核酸监测A型阳性率为8.61%(其中H9阳性率6.62%,H5阳性率2.65%,H7均为阴性)。A型禽流感病毒核酸阳性样本分布于3个监测县(区),其中1个监测县(区)检出H5、1个监测县(区)检出H9、另一个监测县(区)检出H5和H9。不同监测场所环境样本禽流感病毒核酸检测结果显示,城乡活禽市场样本阳性率最高。结论宁夏监测点环境中存在H5、H9禽流感病毒,禽流感病毒显地区性分布的特点,城乡活禽市场是禽流感病毒重要的集散地。宁夏尚无人感染H5N1禽流感。     

2011-2012年肇庆市禽流感职业暴露人群及外环境病毒分布监测分析

目的了解肇庆市禽类职业暴露人群禽流感病毒感染状况以及外环境禽流感病毒的分布情况。方法采集禽类职业暴露人员血清样本,用红细胞血凝抑制试验(HI)检测H5N1流感抗体;采集外环境样本,用荧光定量PCR法检测禽流感病毒FluA、H5、H7和H9核酸。结果 2011-2012年共采集职业暴露人员血清样本400份,检测H5N1抗体均为阴性;共采集外环境有效样本202份,检出FluA阳性25份,阳性率为12.38%,其中AH9亚型阳性14份(56.00%),AH7亚型阳性1份(4.00%),A未分型10份(40.00%),未检出AH5亚型。结论肇庆市职业暴露人群尚未发现感染高致病性禽流感H5N1病毒;外环境存在禽流感病毒的污染,H9亚型是主要的病原体。     

Potential infections of H5N1 and H9N2 avian influenza do exist in Guangdong populations of China

Background Southeast China is one of the sites of influenza origin. During 2003-2004, nine avian influenza outbreaks took place in Guangdong Province. But no human case was reported. To examine the status of potential human infection by human influenza （H1N1, H3N2） and avian influenza （H5N1, H7N7, H9N2） in the avian influenza epidemic area of Guangdong Province, China, we conducted a seroepidemiologic survey in the people of this area from April to June of 2004.
Methods Three out of 9 H5N1 avian influenza affected poultry areas in Guangdong were randomly selected, and the population living within 3 kilometers of the affected poultries were chosen as the survey subjects. One thousand two hundred and fourteen people were selected from 3 villages at random. Human and avian influenza antibody titers were determined by hemagglutination-inhibition （HI） test and microneutralization test （MNT）.
Results The positive rate of antibody to H5N1 was 3.03% in the occupational exposure group and 2.34% in general citizens group; that of H9N2 was 9.52% in the occupational exposure group and 3.76% in the general citizens group. Moreover one case in the occupational exposure group was positive for H7N7. One year later, all previously positive cases had become negative except for one H5N1-positive case.
Conclusion The observations imply that H5N1 and H9N2 avian influenza silent infections exist in Guangdong populations.     

Hospitalized patients with novel influenza A (H1N1) virus infection: Shanghai, June–July 2009

Background From late May 2009, sporadic imported cases of novel influenza A （HIN1） were continuously confirmed in Shanghai, but there were few reports on its clinical presentation in China. The aim of the study was to investigate the demographic and clinical features of the laboratory-confirmed cases and the treatment with oseltamivir. Method We performed a retrospective study in the Shanghai Public Health Clinical Center （SHAPHC）, reviewing the medical records of the laboratory-confirmed patients derived from June 10 to July 20, 2009. Results A total of 156 cases were enrolled, of whom 152 had a history of recent travel. The mean age was 22.6 years and 89 cases （57.1%） were males. The most common symptoms were fever, cough, and sore throat, with children more likely to run a temperature above 38.5℃ than adults. The mean leucocyte count was 5.4×10^9/L, the mean neutrophil count 3.2×10^9/L and the mean lymphocyte count 1.4×10^9/L. Other findings included a normal range or elevated level of C-reactive protein （CRP） and glutamic-pyruvic transaminase and a normal or decreased level of prealbumin; the levels of prealbumin and CRP were significantly lower in the children than in the adults. Fifty-two patients had abnormal chest CT results, with small unilateral or bilateral pulmonary infiltrates, axillary and mediastinal lymphadenopathy and local pleural thickening, while no cases showed symptoms of hypoxia. All the patients received oseltamivir and recovered without complications, but the duration of fever and virus shedding were significantly longer in the children than in the adults. Conclusions Travel-related circulation may be an important reason for the H1N1 epidemic in the non-epidemic areas, and the virus caused mild respiratory symptoms. The infection in children was more severe in terms of prealbumin levels, temperature, the duration of fever and virus shedding. Oseltamivir was effective for H1N1, but more effective in the adults than in the children.     

Sixty-two severe and critical patients with 2009 influenza A (H1N1) in Shanghai, China

Background  Pandemic influenza A (H1N1) emerged rapidly in China in May 2009. Preliminary comparisons with seasonal influenza suggest that pandemic 2009 influenza A (H1N1) disproportionately affects younger ages and causes generally mild disease. To characterize disease progress, comorbidities, and treatment outcomes among consecutive severe and critically ill patients in a hospital served as a reference center for the care of patients with H1N1 in Shanghai, China.

Methods  A retrospective study on 62 severe and critically ill patients with 2009 influenza A (H1N1) was conducted in Shanghai Public Health Clinical Center. Demographic data, symptoms, comorbidities, disease progression, treatments, and clinical outcomes were collected for analysis.

Results  Sixty-two severe or critically ill patients were admitted to the hospital with confirmed 2009 influenza A (H1N1) infection. The median age of the study cohort was 40 years old with a range from 18 years to 75 years, and 67.7% were males. All patients presented with fever and respiratory symptoms. At presentation, 34 patients (54.8%) had comorbidities such as smoking (29.0%), hypertension (29.0%) and hepatitis B virus infection (9.7%). The median time from symptom onset to hospital admission was 6 days (interquartile-range 3–14 days) and 23 critically ill patients were admitted to Intensive Care Unit after admission. All the patients received neuraminidase inhibitors (oseltaminir), while 60 patients (96.7%) were treated with antibiotics, and 39 (62.9%) with corticosteroids. Twenty-three critical cases received noninvasive mechanical ventilation on the first day of admission, and 3 of them ultimately required invasive ventilation. Four death reports (6.5%) were filed within the first 14 days from the onset of critical illness with the primary causes of severe acute respiratory distress syndrome, hypoxemia, or complications, secondary infection and sepsis, pyopneumothorax and stroke.

Conclusions  Severe illness from 2009 influenza A (H1N1) infection in Shanghai occurred among young individuals. Critical cases were associated with severe hypoxemia, multisystem organ failure, and a requirement for mechanical ventilation. Most patients had a good prognosis.

     

甲型H1N1、季节性H1N1及H3N2亚型流感病毒的多重荧光RT-PCR方法的建立

目的构建一种可同时检测甲型H1N1、季节性H1N1、H3N2亚型流感病毒的多重荧光RT-PCR方法。方法根据不同流感亚型HA与NA的差异,设计五对引物及五条探针,构建合适的检测体系,分析特异性、灵敏度、可重复性、仪器适用性,并将其与常用检测试剂盒进行比对。结果本研究成功构建多重荧光RT-PCR检测体系,能同时检出甲型H1N1、季节性H1N1及H3N2亚型流感病毒,检测灵敏度为101~102拷贝/μl,可重复性好(变异系数为0.47%~4.03%),比常用检测试剂具有更好的荧光值水平,可适用于多种常见的荧光定量PCR仪。结论本方法所构建检测流感亚型体系具有较好的特异性、灵敏度、可重复性、仪器适用性,适用于各基层疾控及医疗机构。     

重症孕妇甲流患者治愈1例附文献复习

2009年新型甲型H1N1流感(以下简称"甲流")在全球范围流行,各国积极应对.孕妇由于生理及解剖上的改变而成为易感人群,且易发展为重症;同时因涉及产妇和胎儿2条生命,治疗难度大,孕妇及胎儿的死亡风险亦大.     

国内H5N1禽流感文献计量分析

以中国学术期刊网络出版总库和万方医学网为统计源,对国内H5N1禽流感期刊文献从年度发文量、期刊分布、核心作者、单位分布、地区分布几方面进行统计分析,以了解我国H5N1禽流感文献分布特点和研究现状,为相关学者进行研究提供参考信息。     

双重荧光定量RT-PCR快速检测流感病毒H1、H3亚型的研究

目的 利用荧光定量RT-PCR技术建立一种快速检测流感病毒H1、H3亚型的方法.方法 根据H1、H3亚型流感病毒HA基因的相对保守序列,设计两对引物及其相应的Taqman探针,利用一步法RT-PCR试剂盒建立优化反应体系后,将荧光定量RT-PCR的产物采用10倍稀释法,即107～100 copies/μl,再次用荧光定量PCR方法检验建立体系的灵敏度和重复性,并建立相对定量标准曲线;利用多种流感病毒和具有相似临床症状的呼吸道病毒检验建立体系的特异性.结果 H1和H3亚型流感病毒的检测灵敏度为102 copies/μl,扩增效率分别为101.35％和113.28％,标准曲线相关系数大于99％,重复性良好,特异度实验未发现有非特异性扩增.结论 本研究建立的双重荧光定量RT-PCR技术可以快速、准确地检测H1、H3亚型流感病毒.     

Influenza A pandemic (H1N1) 2009 virus infection

The clinical spectrum of the 2009 pandemic influenza A (H1N1) infection ranged from self-limited mild illness to progressive pneumonia, or even a fatal outcome. We summarize the clinical manifestations, risk factors for severe and fatal cases, pathologic findings and treatment of this disease in this paper based on current reports from different regions of the world.

     

兰州市2009年甲型H1N1流感流行特征分析

目的分析兰州市2009年甲型H1N1流感流行特征,为制定和调整甲型H1N1流感防制措施提供依据。方法应用描述流行病学方法进行分析,对通过《疾病监测信息报告管理系统》网络直报的甲型H1N1流感发病例数,地区分布、时间分布和人群分布等进行分析。结果兰州市2009年共报告甲型H1N1流感1 148例（实验室确诊1 064例,临床诊断84例）,发病率为35.16/10万;发生重症及危重病例64例,死亡12人;报告24起学校甲型H1N1流感暴发疫情,共计发病338例;发病高峰为10月中旬～11月上旬,高峰期共报告病例629例,占总病例数的54.79%;发病年龄主要分布在7～24岁,共报告838例,占总发病数的73.00%;发病以学生为主,报告809例,占70.47%。结论预防和控制甲型H1N1流感的重点人群为学生,安排学生及早接种甲型H1N1流感疫苗,采取综合措施防范学校的暴发流行是控制本病的关键。