南昌市活禽市场禽流感病毒及从业人员特征分析

目的 了解南昌市活禽市场管理措施实施情况，活禽职业人群的流行病学特征和市场禽流感病毒污染现状。方法 采用概率比例规模抽样法（probability proportional to size sampling，PPS）抽取南昌市76家活禽市场及其职业人群作为调查对象。自制问卷收集活禽市场管理措施实施情况、活禽职业人群的人口统计学和职业暴露信息。实时荧光定量RT-PCR检测环境标本禽流感病毒核酸并分型。结果 76家市场中，55.26%（42/76）实施一日一清洗；76.32%（58/76）实行一周一消毒；97.37%（74/76）现场宰杀活禽；69.74%（53/76）活禽存栏过夜。390名从业人员的平均累计职业暴露时间为13.00年（6.12～20.00年），主要暴露方式为宰杀（72.56%）和销售（55.90%）；11.79%近期接触过病死禽。474份环境标本中，75（15.82%）份A型流感病毒核酸阳性，其中H9阳性44份，H5阳性16份，H7阳性11份，H10阳性2份。结论 南昌市活禽市场禽流感防控措施未充分落实，市场禽流感病毒污染较为严重，提示需要进一步加强市场防控措施实施力度，降低活禽职业人群和市场顾客的感染风险。

Epidemiological characteristics of live poultry markets and poultry related workers in Nanchang

Objective To understand epidemiological characteristics of live poultry markets (LPMs) and related workers, and the contamination status of LPMs in Nanchang. Methods LPMs and poultry related workers were randomly selected as study subjects by using Probability-Proportional-to-Size Sampling. Self-designed questionnaires were used to collect information of LPMs and poultry related workers. Sewage, poultry fresh feces and smears of poultry cage samples were collected to detect subtypes of avian influenza viruses using real-time RT-PCR. Results A total of 76 LPMs and 390 poultry workers were investigated. Of total LPMs, 55.26% (42/76) were cleaned every day, 76.32% (58/76) were sterilized at least one time per week, only two rested for one day per month, 97.37% (74/76) slaughtered poultry and 69.74% (53/76) kept live poultry overnight in markets. The median cumulative time of poultry workers' exposure to live poultry was 13.00 years (inter-quartile range: 6.12 to 20.00 years). Of the 390 poultry workers, 72.56% reported their exposure to live poultry through slaughtering and 55.90% through sale, and 11.79% reported having direct contact with sick or dead poultry recently. 474 environment samples were collected from LPMs. Of these, 75 were positive for influenza A virus, with an overall positive rate of 15.82%. Among these 75 positive samples, 44, 16, 11 and 2 were positive for H9, H5, H7 and H10, respectively. Conclusions The avian influenza control measures were insufficient in LPMs, which were heavily contaminated in Nanchang. Further management of the LPMs should be employed to reduce the infection risk of avian influenza virus for live poultry workers and customers visiting LPMs.