内蒙古自治区阿拉善盟首例人感染H7N9禽流感病例流行病学调查

目的分析内蒙古阿拉善盟首例人感染H7N9禽流感病例流行病学特征,为H7N9禽流感防控提供科学依据。方法调查H7N9禽流感病例的发病和就诊经过、可能感染来源、传播途径及暴露因素等,同时开展外环境采样检测和疫点消毒。结果首例人感染H7N9禽流感本地感染病例为82岁男性城市居民,3月26日因发热、咳嗽、咳痰前往医院就诊,症状加重后于3月31日转入甘肃省酒泉市某医院,4月4日采集病例下呼吸道痰液进行检测为H7N9病毒核酸阳性。患者家客厅正对的养殖点外环境和活禽监测H7N9禽流感核酸检测结果为阳性。结论感染来源可能为暴露于染毒的养殖环境而感染,为一起外省输入染疫禽只导致人感染H7N9的事件。建议加强活禽市场管理,严格活禽调运措施,禁止输入未经农业部门检疫合格的禽类。当地医务人员缺乏相关诊断和处置能力,建议加强培训,提高早诊早治意识。

Epidemiological investigation on the first case of H7N9 subtype human avian influenza virus infection,Alxa of Inner Mongolia

To analyze the epidemiological characteristics of the first diagnosed case of H7 N9 subtype human avian influenza virus infection in Alxa, and to provide scientific basis for the prevention and control of it. Methods The onset, treatment history, probable infection source, transmission route and exposure factors of H7 N9 were investigated. Meanwhile, external environmental surveillance and epidemic focus disinfection were implemented. Results The first local case of human infection with H7 N9 avian influenza was an 82-year-old male urban resident. He went to the hospital for treatment due to fever, cough and phlegm on March 26. His condition rapidly worsened and was transferred to a hospital in Jiuquan City, Gansu Province on March 31. On April 4, throat swab and sputum from lower respiratory tract specimens of the patient were positive for H7 N9 subtype human avian influenza viral nucleic acid based on the real-time PCR test. The H7 N9 avian influenza nucleic acid test results of the environment outside the breeding site and live poultry monitoring in the living room of the patient were positive. Conclusion The infection source may be the infected breeding environment, and an event of human H7 N9 infection caused by imported infected poultry from other province. It is suggested to strengthen the market management of live poultry, strict measures to its transfer, and prohibit the poultry import without qualified quarantine by the agricultural department. The local medical staffs are lacked of the ability of diagnosis and disposal, so it is suggested to the stregthen the training to improve the awareness of early diagnosis and treatment.