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.     

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.     

中国人感染H5N1亚型高致病性禽流感病例病毒分离培养探讨

目的 分析中国大陆人感染H5N1高致病性禽流感病例标本采集和病毒分离培养之间的关系.方法 对2005年10月至2009年3月中国大陆人感染H5N1高致病性禽流感病例标本进行病毒分离培养.结果 标本采集时间主要集中在发病后的0～14 d,其中0～7 d采样的标本阳性率分布相对集中,病毒分离的效果要更加显著;标本采集类型主要为呼吸道标本,其中下呼吸道标本的病毒分离阳性率分布较集中,病毒分离效果也更明显.结论 人禽流感病例标本采集时间及标本的采集类型对病毒分离有一定的影响,应在发病的急性期侧重于采集下呼吸道标本,这样利于提高病毒分离的阳性率.     

2016—2018年长沙市人群及活禽市场环境H5N6亚型禽流感病毒监测分析

目的:开展2016—2018年长沙市人群感染和活禽市场(live poultry markets, LPMs)环境污染H5N6亚型禽流感病毒(avian influenza virus, AIV)监测,为防控人感染H5N6亚型AIV提供实验室数据。方法:采集2016—2018年长沙市流感样病例和不明原因肺炎病例咽拭子6...     

中国大陆首例人感染高致病性禽流感病毒(H5N1)病例的实验室诊断

目的 对2005年10月湖南省湘潭市湘潭县发生的一名不明原因肺炎病例进行实验室检测,以确定导致该病例的主要病因.方法 采集病例呼吸道标本以及血清标本,对呼吸道标本利用分子鉴别诊断技术以及RT-PCR和实时荧光定量RT-PCR检测病毒核酸;通过血凝抑制试验以及微量中和试验检测血清中的特异性抗体.结果 该病例所有的呼吸道标本H5N1病毒特异性核酸及病毒分离均为阴性.红细胞凝集抑制及微量中和实验显示,恢复期血清较急性期血清H5N1特异性抗体阳转并且有4倍以上增高.结论 通过实验室检测结果分析,该病例为中国大陆第一例人感染高致病性禽流感病毒（H5N1）实验室确诊病例.     

中国职业暴露人群感染H6N6禽流感病毒血清学调查

目的 系统评估我国职业暴露人群感染H6N6禽流感病毒的状况.方法 本研究利用我国2009-2011年开展的高致病性H5N1禽流感病毒职业暴露人群血清学监测所采集的近15 000份血清标本,开展H6N6禽流感病毒血清学调查.结果 本研究中检测到H6N6禽流感病毒阳性血清共10份,分别来自不同的职业暴露人群,包括活禽市场、家禽规模养殖场、家禽散养户、屠宰加工场和野生候鸟栖息地.从地域上看该10份阳性血清来自8个不同的省份,分布在我国的南北方.结论 这是我国大陆地区首次报道人感染H6亚型禽流感病毒.     

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.     

2015—2016年济南市活禽市场禽流感病毒监测分析

目的 了解济南市活禽市场外环境样本中甲型禽流感病毒动态分布状况,分析禽流感病毒污染特征.方法 2015年11月至2016年10月,选择济南市所属槐荫区活禽批发市场与历城区活禽零售市场进行外环境样本采集,样本类型包括禽处理台表面擦拭物、笼具表面擦拭物、粪便标本、清洗禽类的污水、禽类饮用水等.应用荧光定量RT-PCR方法对样本进行甲型流感病毒核酸检测,阳性样本进一步进行H5、H7及H9亚型检测.采用x2检验比较不同类型活禽市场、不同类型样本各亚型禽流感病毒核酸阳性率差异.结果 全年共采集2943份禽流感外环境样本,甲型禽流感病毒核酸阳性样本检出率为13.73%(404份),H5、H7与H9亚型检出率分别为4.52%(133份)、0.07%(2份)和8.49%(250份).五种不同类型样本中,甲型禽流感病毒阳性率最高的为禽处理台表面擦拭物(21.88%),最低的为禽类粪便(9.64%)(x2=38.535,P<0.001).但在活禽批发市场中,甲型禽流感病毒阳性率最高的样本为禽类饮用水(46.60%),零售市场中阳性率最高的样本为禽处理台表面擦拭物(18.65%).环境样本中甲型禽流感病毒的波动呈季节性趋势,冬春季节阳性率较高,最高为12月份,5—9月呈低发平缓趋势.结论 济南市活禽市场环境存在禽流感病毒的污染,并以H5和H9亚型为主.活禽市场中禽类饮用水与零售市场中禽类处理台面的病毒检出率最高.     

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.     

Clinical and epidemiological survey and analysis of the first case of human infection with avian influenza A(H7N9) virus in Hangzhou, China

To investigate and report on the clinical and epidemiological characteristics of the first case of human infection with avian influenza A(H7N9) virus in Hangzhou, China. A field epidemiological survey was used to study the first case in Hangzhou. The patient was a 39-year-old male chef with a history of exposure to a farm product market and to poultry prior to the onset of disease on 15 March 2013. He had diarrhea, chills, pyrexia, and intermittent cough with freshly red foamy bloody sputum early in his disease. His fever > 39 °C continued for a week with rapid progression. Computed tomography findings showed extensive bilateral consolidation, followed by multiorgan failure. The patient died on the morning of 27 March. His infection was eventually confirmed 1 week later on 3 April. Flu-like symptoms including fever and cough were found in 46 of his 138 close contacts. This was the first case of human infection with avian influenza A(H7N9) virus in Hangzhou. None of the close contacts had onset of the disease. The case patient’s condition progressed rapidly. The source of infection might be his exposure to the farm product market, but the mode of exposure remains unclear.     

Human and avian influenza viruses target different cells in the lower respiratory tract of humans and other mammals

Viral attachment to the host cell is critical for tissue and species specificity of virus infections. Recently, pattern of viral attachment (PVA) in human respiratory tract was determined for highly pathogenic avian influenza virus of subtype H5N1. However, PVA of human influenza viruses and other avian influenza viruses in either humans or experimental animals is unknown. Therefore, we compared PVA of two human influenza viruses (H1N1 and H3N2) and two low pathogenic avian influenza viruses (H5N9 and H6N1) with that of H5N1 virus in respiratory tract tissues of humans, mice, ferrets, cynomolgus macaques, cats, and pigs by virus histochemistry. We found that human influenza viruses attached more strongly to human trachea and bronchi than H5N1 virus and attached to different cell types than H5N1 virus. These differences correspond to primary diagnoses of tracheobronchitis for human influenza viruses and diffuse alveolar damage for H5N1 virus. The PVA of low pathogenic avian influenza viruses in human respiratory tract resembled that of H5N1 virus, demonstrating that other properties determine its pathogenicity for humans. The PVA in human respiratory tract most closely mirrored that in ferrets and pigs for human influenza viruses and that in ferrets, pigs, and cats for avian influenza viruses.     

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.     

Evaluation of a rapid test for detection of H5N1 avian influenza virus

The performance of H5 Dot ELISA, a rapid test for detection of avian H5N1 influenza virus, was evaluated using 30 H5N1 strains belonging to 10 major genetic groups of H5N1 influenza virus, 14 strains of non-H5N1 influenza virus and 652 field samples collected from healthy and diseased chickens from markets and poultry farms. The detection limit of the test for all 30 strains of H5N1 virus was < or = 0.1 hemagglutinin (HA) units and the test yielded a negative result when tested against 100 HA units of the non-H5N1 viruses. The test gave a positive result for 87 of the 106 poultry samples from which H5N1 virus was isolated by culture and 3 of 546 culture-negative poultry samples. Compared with virus culture, the overall prediction rate of the test was determined to be 96.6%; the positive prediction rate was 96.7% and negative prediction rate, 96.6%. The false positive rate was 0.5% and false negative rate 17.9%. Considering that the test is also convenient to use, it was concluded that H5 Dot ELISA is suitable for field use in the investigation of H5N1 influenza outbreaks and surveillance in poultry.     

Genome-sequenee Analysis of the Pathogenic H5N1 Avian Influenza A Virus Isolated in China in 2004

Analysis of the sequences of the genome of the avian influenza A/chicken/Hubei/327/2004 (H5N1) virus, isolated from a poultry farm during the outbreak of avian influenza (AI) in Hubei Province, central China, in the spring of 2004, revealed that the hemagglutinin (HA) gene of the virus was genetically similar to those of the H5 highly pathogenic avian influenza virus (HPAI). Notably, the neuraminidase gene of the virus had a 20-amino acid deletion in the stalk region and a 5-amino acid deletion in the NS gene which belonged to allele B. Furthermore, the internal genes (PB2, PA, NP, M2) of the A/chicken/Hubei/327/2004 virus with the particular amino acid residues were more closely related to H5N1 viruses of 2000–2003 isolated in Hong Kong and the AIV of Thailand and Vietnam in 2004, but less likely to evolve from the viruses of Hong Kong 1997. Finally, our results demonstrated that the influenza A/chicken/Hubei/327/2004 (H5N1) virus was similar to those of the AI viruses isolated from Hong Kong (2000–2003), Vietnam, and Thailand rather than the viruses from the 1997 lineage of Hong Kong and with closest genetic relatives to the influenza A/Chicken/Hong Kong/61.9/02 (H5N1) virus. These data suggest that the influenza A/chicken/Hubei/327/2004 (H5N1) virus which circulated in central China derived its internal gene from a virus similar to the influenza A/Chicken/Hong Kong/61.9/02 (H5N1) virus.