邵阳市2009年流感流行病毒核酸检测结果分析

目的对疑似流感疫情标本进行核酸检测、明确感染因子,为邵阳市流感的防控提供科学依据。方法采用RT-PCR法及Real-Time RT-PCR法对可疑咽拭子标本进行流感病毒核酸分型检测。结果 958份可疑咽拭子标本中有483份流感病毒核酸阳性,阳性率50.42%,其中季节性甲型（甲1亚型/甲3亚型）流感核酸阳性107份,占11.17%;乙型流感核酸阳性13份,占1.36%;甲型H1N1核酸阳性363份,占37.89%.7-24岁年龄段H1N1检测阳性率为73.83%。60岁以上年龄段阳性率仅为1.38%。结论 2009年邵阳市检出的流感流行病毒株以甲型H1N1流感病毒为主。Real-Time RT-PCR技术是流感疫情临床病例诊断可靠的快速诊断方法。     

天津地区2009年流感病原学监测分析

目的:观察2009年天津市流感流行趋势、流感样病例群体暴发和甲型H1N1重症病例病原学监测情况。方法:对2009年国家级流感样病例监测哨点医院采集的流感样病例(ILI)咽拭子标本,采用病毒分离鉴定和real-time PCR检测。对疑似甲型H1N1流感病毒感染的重症病例、集中暴发病例及散发病例的呼吸道标本进行real-time PCR检测。同时对2009年5月-7月的ILI散发病例进行RT-PCR和Real-time PCR法检测,比较两种方法检测结果。对2009年9月份国家哨点医院采集标本进行核酸检测和病毒分离两种方法进行。结果:2009年共采集国家级哨点医院流感样病例标本3264份,970份流感病毒阳性,总检出率为29.7%,其中甲型H1N1亚型占55.9%(542/970株),季节性H3占26.5%(257/970株),季节性H3占26.5%(257/970株),季节性H1占7.9%(77/970),B型占0.9%(9/970株)。10月甲型H1N1明显上升,11月达高峰(91.1%),15～岁年龄段阳性率最高(72.7%)。650份疑似甲型H1N1流感重症病例中,196例(30.2%)为阳性,25～岁年龄组阳性数最高(106例),男女比例相似。321份暴发疫情标本中,190份为流感病毒阳性(59.2%)。其中甲型H1N1占44.5%(143/190),季节性H3占12.8%(41/190),B型占1.9%(6/190),未检出季节性H1。4、5月以B型为主,9～12月以甲型H1N1为主。主要为5～25岁学生。对129例散发ILI病例同时进行RT-PCR和Real-time PCR法检测,结果完全一致,均为18例流感病毒阳性。对9月份采集的474份标本进行核酸检测和病毒分离,178份核酸检测阳性,其中107例分离出毒株。结论:2009年天津地区同时存在甲型H1N1、季节性H1、H3和B型流感病毒,甲型H1N1流感病毒为优势流行型。重症病例中30.2%是由甲型H1N1流感病毒引起。暴发疫情以甲型H1N1流感病毒为主。RT-PCR和Real-time PCR法均可用于检测流感病毒。ILI核酸检测阳性率高于病毒分离阳性率。     

淮北市2009～2011年流感病原学监测结果分析

目的通过采集流感样病例咽拭子标本进行流感病毒核酸检测,并对检测结果进行流行病学分析,了解流感的流行规律,为制定有效的防控措施提供依据。方法2009年9月-2011年2月,由哨点医院采集流感样病例咽拭子标本,用RT—PCR方法进行流感病毒核酸检测。结果淮北市2009～2011年12月共检测流感样病例咽拭子1620份,核酸阳性标本242例,阳性率为14．94％。其中,甲型H1N1196例,主要集中在2009年8月～12月;季节性H12例,季节性H334例,B型流感病毒10例。结论2009—2011年流感监测结果显示,2009～2011年,淮北市流感疫情以甲型H1N1为主,伴有甲型H3亚型和乙型散发。流感的发病人群以5—59岁年龄段为主,是流感防控的重点人群。     

黄山市2009～2012年流感病原学监测结果分析

目的通过流感样病例监测,了解黄山市流感病原学分布情况,为临床诊断和预防控制提供依据。方法采集哨点医院流感样病例的咽拭子标本,采用RealTime RT-PCR方法检测流感病毒核酸并鉴定亚型。结果黄山市2009年8月到2012年12月哨点医院共采集到咽拭子标本1 800份,核酸检测阳性标本共422份,阳性率为23.44%。结论黄山市2009年主要以甲型H1N1流感为主,2010年主要以B型为主,2011年主要以B型和甲型H1N1流感为主,2012年主要以B型和季H3型流感为主,流感发病主要在冬春季节。     

2011年-2013年宿迁市流感病毒病原学监测分析

目的分析宿迁市流行性感冒(流感)监测情况和流感病毒病原季节性分布特点。方法对监测哨点医院的儿科、内科、急诊科和发热门诊的流感样病例咽拭子进行采集,24 h内采用real-time PCR进行核酸检测,流感病毒分离采用狗肾传代细胞(MDCK),流感病毒亚型鉴定采用红细胞凝集抑制试验。结果 2011年-2013年共采集流感样病例标本2 098份,标本中流感病毒核酸检测阳性275份,阳性率为13.1%,其中甲型H3N2流感占40.0%,乙型占35.6%,新甲型H1N1占24.0%,甲型(未分型)占0.36%。275例real-time PCR法检测阳性的样本经MDCK培养,共有123例阳性,阳性率为44.7%,其中甲型H3N2占40.6%,B型(Victoria系)占32.5%,新甲型H1N1占26.8%。结论甲型H3N2、B型(Victoria系)和新甲型H1N1作为优势病原交替出现,具有一定的季节性,同时发现新甲型H1N1成为甲型流感病毒的重要流行株。     

2009年泰安市流感监测资料分析

[目的]分析2009年泰安市流感流行特征及病原变化情况。[方法]对2009年5月11日至12月31日泰安市流感监测哨点医院和流感暴发疫情监测资料进行分析。[结果]2009年,监测哨点医院门诊流感样病例占同期门急诊就诊总数的4.97%,这一比例,第20～35周为2.71%,第35～42周为7.06%,第43～50周为7.84%,第51～53周为3.70%;检测690例病人鼻咽拭子或下呼吸道标本,流感病毒核酸阳性率为45.36%,阳性标本中甲型H1N1流感病毒占87.54%。期间发生流感样疾病暴发疫情61起,其中由甲型H1N1流感病毒引起的占83.61%。[结论]甲型H1N1流感病毒是2009年流感流行季节的优势毒株。     

清远市2011年流感监测结果分析

目的:分析清远市2011年流感监测结果,了解流感流行特征,为清远市流感防控工作提供科学依据。方法:选择清远市人民医院作为流感监测的哨点医院,采集疑似流感样患者咽拭子标本。采用实时荧光定量RT-PCR方法检测流感病毒核酸。结果:清远市2011年检测疑似流感样患者咽拭子标本共484份,流感病毒核酸阳性为36份,总阳性率为7.44%。其中新型甲型H1N1和乙型流感分别占69.44%、16.67%;未分离到季节性H1和H3亚型,A通用型未分型占13.89%。清远市2011年流感活动高峰主要集中在1月-3月份和12月份。结论:清远市2011年春季以新型甲型H1N1流感流行为主,然后逐渐过渡为乙型流感。     

江苏省连云港市2009～2010年流感监测分析

目的监测流感流行趋势,了解连云港市流感病毒的活动特点,为制定流感防治策略提供科学依据。方法用实时荧光定量RT-PCR方法对流感样病例标本进行核酸检测分型,并对连云港市2009～2010年的流感样病例监测资料进行描述分析。结果 2009年7月～2010年12月,从哨点医院采集的2008份疑似流感样病例标本中,检测流感病毒核酸阳性530份,阳性率为26.39%,其中新甲型H1N1型263份,H1型7份,H3型222份,B型38份。2009年8月出现新甲型H1N1疫情,9月为高峰期。2010年高峰月出现在3月和9月。结论连云港市可能存在春季和秋季两个流感流行高峰,应进一步加强对流感的监测。     

2010年开封市流行性感冒监测分析

目的对开封市2010年流行性感冒(流感)监测结果进行分析,了解流感的流行趋势、病原学变化特点,为今后流感防治工作提供科学指导。方法哨点医院对流感样病例进行监测,并按要求采集流感样病例咽拭子标本运送至流感监测网络实验室,流感监测网络实验室在24h内采用real-time RT-PCR法进行核酸检测,并完成流感病毒的分离鉴定。结果 2010年开封市流感监测哨点医院共监测门、急诊就诊病例91661例,流感样病例(ILI)853例。全年共采集流感样病例咽拭子标本571例,经实验室检测,新甲H1N1流感病毒18例(占3%),A未分型57例(占10%),B型9例(占2%),季H1和季H3均未检出,全年无流感及甲型H1N1流感暴发疫情的发生。结论流感发病有季节性,2010年第3周流感样病例数达高峰,随后呈明显下降趋势,流感样病例构成以25～年龄组为主,流感病毒以A未分型为优势流行株。     

深圳市龙岗区流感监测结果分析

目的了解深圳市龙岗区2009年4月-2010年5月流感流行规律,为有效防制提供依据。方法通过流行病学、血清学和病原学监测,对深圳市龙岗区流感流行情况进行分析。结果深圳市龙岗区2009年4月-2010年5月监测流感样病例(ILI)43 249例,占监测就诊病例总数的8.42%;全年均有病例发生,6月和7月ILI病例数最多;流感样病例主要集中在0～和5～岁年龄组,占79.4%;采集ILI鼻咽拭子标本520份,分离出91株流感病毒,阳性率为17.5%,新甲型H1N1 19株,H1N1亚型7株,H3N2亚型14株,B(Victoria)亚型51株。流感暴发疫情主要发生在中、小学校,占81.2%。核酸检测以季节性甲流和新甲型H1N1流感为主(81.2%)。结论深圳市龙岗区全年均有流感样病例发生,以夏季和冬季为高发季节,主要流行株为甲型H1N1流感病毒株和B型流感病毒(Victoria系),流感监测对预防流行有重要意义。     

2010年重庆市流感监测结果分析

目的分析重庆市2010年流感流行特征,为制定防控策略提供科学依据。方法对重庆市2010年流感监测结果进行描述性流行病学分析,主要包括各级医疗机构报告的临床诊断病例、哨点医院流感监测、暴发疫情监测及网络实验室流感样病例病原学监测情况。结果 2010年,重庆市报告甲型H1N1流感病例61例,死亡1例,发病率为0.21/10万,病死率为1.61/10万;报告病例数居26种乙类传染病中第6位。报告季节性流感955例,死亡1例,发病率为3.36/10万,病死率为0.104 7/10万;报告病例数居11种乙类传染病中第5位。2010-01甲型H1N1型为优势毒株;2～6月以季节性B型为优势毒株;7～9月以季节性A型流感为优势毒株,10～12月以A型和B型交替出现。病例分布于全市34个区县,报告病例数居前3位的是涪陵区、渝中区和永川区。报告病例男∶女=1.25∶1,职业以儿童和学生为主。2010年全市报告流感样病例(ILI)相关暴发疫情12起,共报告病例295人,经采样监测,其中10起(83.3%)确认为流感疫情;疫情以3～4月和7～8月为高峰;10起为学校疫情,占83.33%;2起为医院内感染,占16.67%。结论 2010年重庆市流感总体处于低发、散发状态。学校是流感暴发的重点场所,学生是罹患的重点人群。     

宁波市H1N1型流感病毒监测分析

目的了解浙江省宁波市2004-2008年流感流行状况和H1N1型流感变异情况,探索流行规律并为流感防治提供科学依据。方法建立监测哨点,采用流感样病例就诊百分比(ILI%)为流行病学监测指标,并对送检的流感样病例咽拭子或含漱液标本进行病毒分离和鉴定。结果2004年1月-2008年12月,宁波市4家监测哨点医院共报告流感样病例99 333例,流感样病例百分比波动在0.77%~11.66%,平均为4.49%(99 333/2 210 318);共送检流感样病例标本5 784份,分离出流感病毒686株,平均分离率为11.86%(4.14%~22.32%),其中甲1型163株,甲3型492株,乙型31株。宁波市流感活动的季节性规律表现为每年春末(3-4月)和初秋(8-9月)2个ILI%高峰。2006年流行的H1N1亚型与H1N1疫苗株NewCaledonia/20/1999在血凝素蛋白重链(HA1)区氨基酸的差异为7个,2008年流行的H1N1亚型与H1N1型疫苗株Brisbane-59-2007比较,差异已达到6个位点以上。结论ILI%的异常变化与流感病毒变异活动有关;H1N1型流感毒株变异活动加强。     

Demographic Shift of Influenza A(H1N1)pdm09 during and after Pandemic, Rural India

Population-based active surveillance in India showed higher incidence rates for influenza A(H1N1)pdm09 among children during pandemic versus postpandemic periods (345 vs. 199/1,000 person-years), whereas adults had higher rates during postpandemic versus pandemic periods (131 vs. 69/1,000 person-years). Demographic shifts as pandemics evolve should be considered in public health response planning.     

郫县某学校1起甲型H1N1流感暴发疫情调查

[目的]调查甲型H1N1流感疫情,为今后的疫情处理提供依据。[方法]对2009年9月发生在驻郫县某学校的1起甲型H1N1流感暴发疫情进行现场调查与采样检测。[结果]该校2009年9月6日～24日累计发现流感样病例102例,罹患率为2．12％。102例中,确诊为甲型H1N1流感的3例,甲型非H1N1流感3例,医学观察的轻症病例96例,无重症和死亡病例发生。[结论]这是1起学校甲型H1N1流感暴发疫情,同时存在季节性流感疫情。     

Pandemic influenza vaccination: Will the health care system take its own medicine?

Objective: To identify factors associated with acceptance of the pandemic Influenza A H1N1 California 7/09 vaccine (pH1N1 vaccine) in rural hospital staff. Design: Cross‐sectional group administered survey. Setting: A 58‐bed rural Queensland hospital, over a 10‐day period starting five days after commencement of the pH1N1 vaccination program. Participants: Hospital staff and students. Main outcome measures: Intention to receive pandemic influenza vaccination, seasonal influenza vaccination. Results: The survey was completed by 252 staff and students (full response rate 76.1%, cooperation rate 98.4%). The majority of respondents had already decided whether or not to receive the pH1N1 vaccine: 111 (44.0%) intended to be vaccinated, 63 (25.0%) intended not to be vaccinated and 78 (31.0%) were undecided. Of 125 staff who had received the seasonal influenza vaccine, 86 (68.8%) intended to receive the pandemic vaccine. Respondents were less likely to state acceptance of the pH1N1 vaccine if they identified concern about vaccine adverse reactions (odds ratio (OR) 0.29; 95% confidence interval (CI), 0.11–0.78), vaccine safety (OR 0.20; 95% CI, 0.09–0.46), vaccine efficacy (OR 0.20; 95% CI, 0.04–0.87) or perceived limitations of vaccine trials (OR 0.08; 95% CI, 0.01–0.99) as primary reasons discouraging pandemic influenza vaccination. Conclusions: There is considerable concern among rural hospital staff regarding pH1N1 vaccine adverse reactions, safety, efficacy and the adequacy of clinical trials on its use. Education specifically addressing these concerns might increase pandemic vaccine acceptability.     

Report of the 6th meeting on the evaluation of pandemic influenza vaccines in clinical trials World Health Organization,Geneva, Switzerland, 17–18 February 2010

On February 17–18, 2010, the World Health Organization (WHO) convened the 6th meeting on the “Evaluation of pandemic influenza vaccines in clinical trials” to review the progress made on new A (H1N1) 2009 vaccines and prototype H5N1 vaccines and their evaluation in clinical trials. A number of vaccine types were reviewed, including classical egg-derived and cell culture-derived inactivated vaccines, such as split virus or whole-virion vaccines, and live-attenuated vaccines (LAIV), as well as vaccines developed using new technologies. The amount of antigen needed, the effect of adjuvants and the number of doses required to induce adequate antibody responses in various populations, together with the issue of safety of the vaccines, were major topics of the meeting. The effectiveness of H1N1 vaccines and the need for standardization of vaccine potency tests were also discussed. Independent of the vaccine type and the presence or absence of an adjuvant, all A (H1N1) 2009 vaccines were well tolerated, eliciting only mild to moderate local or systemic reactions. For most vaccines tested, a single dose was sufficient to elicit a potentially protective antibody response in the majority of vaccinees >10 years of age. However, a second dose of vaccine was needed to boost immune responses in infants and toddlers 6 months to 3 years of age and, with some vaccines, in children aged 3–9 years.     

惠州市2009年流感监测结果分析

目的了解惠州市2009年度流感的流行特征,探索流行规律,为流感的防治提供科学依据。方法采集哨点医院和暴发疫情流感样病例咽拭子标本,用MDCK细胞进行流感病毒分离,采用实时荧光定量PCR进行流感病毒分型。结果从哨点医院采集的1 482例标本中共分离271份流感病毒,其中A型265株,B(Victoria)型6株;在22起流感样病例暴发疫情中,由新甲型H1N1引起的有16起,86.4%都集中在中小学学校。结论 2009年惠州市流感监测医院的流感样病例全年均有发生,以秋、冬季为高发季节。2009年主要流行毒株为新甲型H1N1毒株。     

深圳口岸121例甲型H1N1流感病例初步分析

目的分析深圳口岸输入性甲型H1N1流感病例流行病学特点及卫生检疫情况,为进一步开展口岸防控工作提供决策依据。方法收集2009年5～8月深圳口岸拦截的甲型H1N1流感确诊病例并对其流行病学和卫生检疫情况进行分析。结果深圳口岸发现的输入性甲型H1N1流感病例主要以青少年为主,占66．11％;除中国香港外,患者主要来自美国和澳大利亚,占30．58％;检出的高峰时间主要有三个,分别为6月23日,7月3日和7月23日。主要检出口岸分别为皇岗口岸,占29．75％;罗湖口岸,占23．97％和深圳湾口岸,占18．18％;发现方式主要为体温监测,占61．98％;该次发现的甲型H1N1流感患者的临床表现温和,与季节性流感相当。结论口岸传染病监测对疫情防控起着重要的把关作用。体温监测是口岸传染病监测重要手段,应进一步加强,同时应加强健康申报和医学巡查工作及时发现有症状人员。国际旅行卫生保健中心口岸工作部的建设为口岸传染病的排查和检出提供了有力的技术保障,这种模式值得研究和探讨。     

Adverse events following pandemic influenza A (H1N1) 2009 monovalent and seasonal influenza vaccinations during the 2009–2010 season in the active component U.S. military and civilians aged 17–44 years reported to the Vaccine Adverse Event Reporting System

BackgroundNo comparative review of Vaccine Adverse Event Reporting System (VAERS) submissions following pandemic influenza A (H1N1) 2009 and seasonal influenza vaccinations during the pandemic season among U.S. military personnel has been published.MethodsWe compared military vs. civilian adverse event reporting rates. Adverse events (AEs) following vaccination were identified from VAERS for adults aged 17–44 years after pandemic (monovalent influenza [MIV], and seasonal (trivalent inactivated influenza [IIV3], live attenuated influenza [LAIV3]) vaccines. Military vaccination coverage was provided by the Department of Defense’s Defense Medical Surveillance System. Civilian vaccination coverage was estimated using data from the National 2009 H1N1 Flu Survey and the Behavioral Risk Factor Surveillance System survey.ResultsVaccination coverage was more than four times higher for MIV and more than twenty times higher for LAIV3 in the military than in the civilian population. The reporting rate of serious AE reports following MIV in service personnel (1.19 per 100,000) was about half that reported by the civilian population (2.45 per 100,000). Conversely, the rate of serious AE reports following LAIV3 among service personnel (1.32 per 100,000) was more than twice that of the civilian population. Although fewer military AEs following MIV were reported overall, the rate of Guillain–Barré Syndrome (GBS) (4.01 per million) was four times greater than that in the civilian population. (1.04 per million).ConclusionsDespite higher vaccination coverage in service personnel, the rate of serious AEs following MIV was about half that in civilians. The rate of GBS reported following MIV was higher in the military.     

Timeliness of syndromic influenza surveillance through work and school absenteeism

In this paper, we investigate the usefulness of work and school absenteeism surveillance as an early warning system for influenza. In particular, time trends in daily absenteeism rates collected during the A(H1N1)2009 pandemic are compared with weekly incidence rates of influenza-like illness (ILI) obtained from the Belgian Sentinel General Practitioner (SGP) network. The results indicate a rise in absenteeism rates prior to the onset of the influenza epidemic, suggesting that absenteeism surveillance is a promising tool for early warning of influenza epidemics. To convincingly conclude on the usefulness of absenteeism data for early warning, additional data covering several influenza seasons is needed.