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．夕h环境存在禽流感病毒的污染,H9亚型是主要的病原体。     

阜阳市职业暴露人群高致病性禽流感H5N1血清流行病学研究

目的对阜阳市职业暴露人群开展高致病性禽流感H5N1抗体调查,明确是否存在隐性感染,了解该病的流行病学规律。方法于2009年5月、12月,分别采集颖上县城乡活禽市场、家禽规模养殖场、家禽散养户集中的地区、家禽屠宰加工厂等地职业暴露人群血清100份和93份,利用单放射免疫扩散溶血技术检测H5N1抗体。结果5月份采集的100份标本中,H5N1抗体阳性3份,阳性率为3．00％;12月份采集的93份标本中,H5N1抗体阳性7份,阳性率为7．53％;两次调查总阳性率为5．18％,两个月份比较差异无统计学意义（χ^2=1．16,P〉0．1）。结论在禽流感职业暴露人群中,存在H5N1隐性感染,感染与季节分布无关。     

广州地区禽H9N2亚型流感病毒的发现及感染人调查

目的 了解广州地区禽流感病毒在家禽中的流行及感染人的情况，防止香港H5N1禽流感在广州地区流行。方法 对广州地区的主要鸡场和农贸市场的家禽和密切接触家禽的职业人群进行病原学和血清学的检测。病毒分离同时采用MDCK细胞和鸡胚双腔接种法；采用微量血凝抑制半致敏法进行血清学检测。结果 从54份鸡咽拭液中分离到1株H9N2亚型流感病毒；鸡及职业人群血对分离的H9N2毒株的血抑抗体阳性率分别为12．8％和15．1％。结论 广州地区鸡群中有H9N2，亚型流感病毒存在，禽H9N2亚型流感病毒能感染人。     

湖北省首例人感染H5N6禽流感病例流行病学调查

目的 对湖北省首例人感染H5N6禽流感病例的流行病学资料进行分析,探讨病例发现过程、调查处理措施、实验室检测方法,为防控人感染H5N6禽流感疫情提供依据.方法 采用描述性流行病学方法,分析湖北省首例人感染H5N6禽流感病例诊治过程、密切接触者信息,开展现场流行病学调查,并采集病例、密切接触者、活禽市场外环境标本进行实验室检测分析.结果 患者2016年4月9日发病,体温40℃,有活禽市场暴露史.发病早期采集的下呼吸道标本(痰液、气管分泌液)为H5N6禽流感病毒核酸阳性,而上呼吸道标本H5N6禽流感病毒核酸检测均为阴性.患者无外出史和H5N6禽流感病例接触史.患者经两个月的治疗痊愈出院.密切接触者58人均未出现发热和呼吸道感染症状.采集病例经常路过的两家活禽市场和一家土鸡专卖店外环境标本共36份,其中检出H5N6禽流感病毒核酸1 1份,阳性率为30.56％.结论 该病例为湖北省首例人感染H5N6禽流感病例,属本地感染的散发病例,未出现人传人.传播途径可能为:活禽市场通过禽-环境-人的途径传播.在病例诊断中,下呼吸道标本(尤其是痰液、气管分泌液)具有重要意义.另外,尽早应用奥司他韦对病例的成功救治起到了重要的作用.     

2004-2012年我国禽流感流行情况

禽流感病毒(AIV)是一类可以引起禽类感染和(或)致病的A型流感病毒,它能引起大多数家禽、野生水禽的感染.部分禽流感病毒已经跨种属传播感染人群,1997年香港第一次报道禽流感H5N1亚型病毒能感染人类,不断出现的H9N2、H7N2、H7N3、H7N7等禽流感亚型感染人类的报道,并显示不同程度的致病性和病死率[1-3].2013年3月在中国首次报道新的基因重组H7 N9亚型禽流感病毒直接感染人类,导致重症肺炎引起死亡[4].     

北京市1例人感染H9N2禽流感病例的流行病学调查与分析

目的 分析北京市人感染H7N9禽流感疫情强化监测中发现的1例人感染H9N2禽流感病例流行病学调查情况,为今后科学防控人感染H9N2禽流感疫情提供参考.方法 采用现场流行病学和实验室检测相结合的方法,收集病例流行病学资料,采集并检测病例、暴露环境和密切接触者等标本,分析流行病学特征和可能的感染来源.结果 病例发病第3日和第7日咽拭子标本检测均为H9N2禽流感病毒核酸阳性.病例发病前10天内无禽类接触史,但病例平时活动有暴露于H9N2禽流感病毒污染环境的可能.密切接触者在医学观察期内均未出现流感样症状.结论 该病例为北京市首例成人感染H9N2禽流感确诊病例,同时也是北京市第二例H9N2禽流感确诊病例.医疗机构加强流感样病例监测是及时发现人感染H9N2禽流感病例的重要手段.     

H5N1亚型禽流感病毒血凝素Th和B细胞表位预测及抗原性分析

目的:预测H5N1亚型禽流感病毒血凝素Th和B细胞相关抗原表位,并初步分析其抗原性.方法:依据近年H5N1亚型禽流感病毒流行趋势,下载得到相关HA蛋白氨基酸序列.进行生物信息学综合分析预测,获得Th和B细胞相关抗原表位,并比较其保守性和特异性.通过BALB/c小鼠和SPF鸡H5N1亚型禽流感病毒阳性血清,初步鉴定候选表位抗原性.结果:综合多项预测及空间构象模拟结果,我们获得了三条候选Th和B细胞表位,分别为HA141～155、HA206～223、HA302～316.候选表位处于H5N1亚型禽流感HA1 蛋白序列上相对保守的区域内,且与目前流行的H5N1亚型禽流感病毒HA相应区域具有较好的一致性.而不同候选表位在BALB/c小鼠和SPF鸡H5N1亚型禽流感病毒阳性血清反应中显示了不同抗体结合能力,预示了其成为功能表位的可能.结论:所筛选的表位具有成为H5N1亚型禽流感病毒HA Th和B细胞相关抗原表位的可能.本研究为深入揭示流感病毒感染与免疫机制,H5N1亚型禽流感功能表位认知及表位疫苗研究奠定了基础.     

一起人感染H7N9禽流感家庭聚集性疫情的流行病学调查分析

目的 调查一起人感染H7 N9禽流感聚集性疫情的流行病学特征,分析病例的感染来源和传播途径.方法 对病例开展现场流行病学调查和实验室检测,对病例感染来源进行调查和外环境采样检测.结果 共发现两名病例,病例为父女关系.两病例发病前有可疑活禽暴露史,居住地附近可疑暴露市场标本检测出H7N9禽流感病毒.病例1在潜伏期内即发病,判断为环境暴露感染;其女儿的发病时间距脱离暴露环境已经10天,而在其父亲发病后曾共同生活,判断由其父亲传染给她的可能性大.结论 本起家庭聚集性疫情中,病例1的感染来源可能为被H7 N9禽流感病毒污染的环境,病例2被病例1传染的可能性更大.     

2017~2018年成都市三区县外环境禽流感监测分析

目的 监测四川省成都市三区县外环境中禽类流行性感冒（禽流感）病毒的分布状况,为人禽流感防控提供参考依据。方法 我中心在2017年5月~2018年5月采用实时荧光定量PCR检测成都市三区县外环境中甲型流感通用病毒,再将阳性标本进行H5、H7、N9和H9分型,采用χ2检验比较定性资料。结果 在497份样本中,甲型流感病毒阳性标本87份,检出率为17.91%;分型实验中,H5、H7、N9和H9分别检出7份、6份、12份和41份,其阳性检出率依次为1.41%、1.21%、2.41%、8.25%,未分型成功23份,占总样本的4.63%。结论 成都市三区县外环境存在禽流感病毒污染,有人感染禽流感风险;需加强对外环境及高危人群禽流感监测,并规范对市场的管理机制,落实消毒和检疫准入等预防措施。     

人感染高致病性禽流感病毒H5N1核酸检测方法的建立及应用

目的 建立人感染高致病性禽流感病毒H5N1的核酸检测方法,用于人感染高致病性禽流感病毒疑似病例临床标本的检测.方法 针对甲型流感病毒保守基因M设计RT-PCR和real-time PCR引物检测是否为甲型流感病毒,同时针对H5N1禽流感病毒设计针对H5和N1基因的特异性RT-PCR和real-time PCR引物作亚型检测,建立禽流感H5N1病毒RT-PCR和real-time PCR检测方法.结果 本研究建立的RT-PCR和real-time PCR方法可以特异性地检测H5N1病毒,并且与人流感病毒H1、H3没有交叉反应.RT-PCR检测方法灵敏度可到1TCID50,real-time PCR灵敏度可达0.01TCID50.利用上述方法检测人感染高致病性禽流感病毒H5N1疑似病例临床标本,从42例不明原因肺炎病例中检测出阳性标本13例.结论 本研究建立的RT-PCR和real-time PCR方法可以用于人感染高致病性禽流感病毒H5N1临床标本的实验室检测.     

Seroprevalence of avian influenza H9N2 among poultry workers in Shandong Province, China

H9N2 avian influenza virus has been circulating widely in birds, with occasional infection among humans. Poultry workers are considered to be at high risk of infection with avian influenza due to their frequent exposure to chickens, but the frequency of H9N2 avian influenza virus infections among them is still indistinct. This study was carried out in order to identify the seroprevalence of H9N2 avian influenza virus among poultry workers in Shandong, China. During the period from December 2011 to February 2012, a total of 482 subjects took part in this study, including 382 poultry workers and 100 healthy residents without occupational poultry exposure. Serum samples were collected and tested for the presence of antibodies against H9N2 avian influenza virus by hemagglutination inhibition (HI) and microneutralization (MN) assays. Nine subjects (9/382?=?2.3 %) were positive for antibodies against H9N2 avian influenza virus among poultry workers by either HI or MN assays using ≥40 cut-off, while none of the 100 healthy residents were seropositive. In conclusion, our study identified H9N2 avian influenza infections among poultry workers in Shandong, China, and continuous surveillance of H9N2 avian influenza virus infection in humans should be carried out to evaluate the threat to public health.     

The first lack of evidence of H7N9 avian influenza virus infections among pigs in Eastern China

In this study, we sought to examine whether evidence existed suggesting that pigs were being infected with the novel H7N9 avian influenza virus. From November 2012 to November 2013, blood was drawn from 1560 pigs from 100 large farms in 4 provinces of eastern China. Many of these pigs were in close proximity to wild birds or poultry. Swine sera were studied using hemagglutinin inhibition (HI) assays and enzyme-linked immunosorbent assays (ELISAs) against the H7 antigen derived from the emergent H7N9 avian influenza virus (AIV). Only 29 of the 1560 samples had HI titers of 1:20 when using the H7N9 AIV antigens, and none of the 29 (H7N9 AIV) HI-positive samples were positive when using ELISA, indicating that no samples were positive for H7N9. The negative results were also verified using a novel competitive HA-ELISA. As pigs have been shown to be infected with other avian influenza viruses and as the prevalence of novel influenza A viruses (e.g., H7N9 AIV) may be increasing among poultry in China, similar seroepidemiological studies of pigs should be periodically conducted in the future.     

北京市首例人感染H9N2禽流感病例的流行病学调查

目的 分析2016年12月北京市朝阳区确诊的l例人感染H9N2禽流感病例流行病学特征.方法 访谈病例发病前后的相关知情人,调查病例发病经过和可能感染来源.采集病例、密切接触者及环境标本,应用实时荧光定量PCR(real-timePCR)方法,检测甲型流感病毒及H9N2禽流感病毒特异的核酸片段.对病例咽拭子标本和l件阳性环境标本中的H9N2禽流感病毒血凝素(Hemagglutinin,HA)基因进行序列测定和分析.结果 病例表现为轻症流感样病例症状,发病前15天曾有活禽市场暴露史.该市场环境标本中H9N2禽流感病毒阳性率为18.2％ (2/11).病例咽拭子标本与市场环境标本中病毒的HA基因高度同源,氨基酸相似度为100％,在进化关系上同属于欧亚系的Y280分支.4名密切接触者在医学观察期内未出现过发热、咳嗽等呼吸道症状.结论 病例感染来源与活禽市场环境暴露有关.加强流感监测以及活禽市场的管理对于防控人感染禽流感疫情具有重要意义.     

Lack of evidence of avian-to-human transmission of avian influenza A (H5N1) virus among veterinarians,Guangdong, China, 2012

BackgroundCases of human infections with H5N1 avian influenza viruses have been reported all over the world with the reason of direct contact with sick or diseased poultry, which suggests the direct contact with poultry may be one of the major risk factors for human infection.ObjectivesIn this study, we estimated the seroprevalence of antibodies against avian influenza A (H5N1) virus in veterinarians with exposure to avians.Study designFrom May 21, 2011 through April 22, 2012, 406 veterinarians exposure to poultry in Guangdong province were interviewed a questionnaire. A serum specimen was collected from participants to test for H5N1 antibodies by HI and NT assay.ResultsNone of the 406 sera from occupationally exposed veterinarians was positive according to the HI test and the NT test with the H5N1 AIV.ConclusionOur seroepidemiologic survey suggests that the risk of avian-to-human transmission of the H5N1 AIV is very low based on the samples that we tested. However, prevention regarding the risk of H5N1 AIV transmission is essential and should be recommended as public health measures.     

Human infection with an avian H9N2 influenza A virus in Hong Kong in 2003

Avian H9N2 influenza A virus has caused repeated human infections in Asia since 1998. Here we report that an H9N2 influenza virus infected a 5-year-old child in Hong Kong in 2003. To identify the possible source of the infection, the human isolate and other H9N2 influenza viruses isolated from Hong Kong poultry markets from January to October 2003 were genetically and antigenically characterized. The findings of this study show that the human H9N2 influenza virus, A/Hong Kong/2108/03, is of purely avian origin and is closely related to some viruses circulating in poultry in the markets of Hong Kong. The continued presence of H9N2 influenza viruses in poultry markets in southern China increases the likelihood of avian-to-human interspecies transmission.     

禽流感与公共卫生

近年来，H5N1亚型高致病性禽流感在东南亚多个国家爆发，给养禽业带来沉重打击。H5N1亚型禽流感病毒还在越南、泰国、印尼、柬 埔寨和中国引起160多人感染，导致半数以上感染者死亡。禽流感这一重大禽类疫病，目前已成为公共卫生面临的最大威胁。本文对流感及流感病毒、H5N1亚型禽流感病毒跨越禽-哺乳动物种间屏障的分子机制进行了综述，并对今后禽流感的防治提出了建议。     

Family Clusters of Avian Influenza A H7N9 Virus Infection in Guangdong Province,China

Since its first identification, the epizootic avian influenza A H7N9 virus has continued to cause infections in China. Two waves were observed during this outbreak. No cases were reported from Guangdong Province during the first wave, but this province became one of the prime outbreak sites during the second wave. In order to identify the transmission potential of this continuously evolving infectious virus, our research group monitored all clusters of H7N9 infections during the second wave of the epidemic in Guangdong Province. Epidemiological, clinical, and virological data on these patients were collected and analyzed. Three family clusters including six cases of H7N9 infection were recorded. The virus caused severe disease in two adult patients but only mild symptoms for all four pediatric patients. All patients reported direct poultry or poultry market exposure history. Relevant environment samples collected according to their reported exposures tested H7N9 positive. Virus isolates from patients in the same cluster shared high sequence similarities. In conclusion, although continually evolving, the currently circulating H7N9 viruses in Guangdong Province have not yet demonstrated the capacity for efficient and sustained person-to-person transmission.