中国内地首例甲型H1N1流感病例发现与处置

目的通过对中国内地首例甲型H1N1流感病例的处置，总结防控经验，为今后处理类似疫情提供科学依据。方法查阅临床病历资料和各级疾控中心流行学调查报告，按照卫生部下发诊断标淮、出院标准和相关防控技术指南，制定防控措施；实验室甲型H1N1流感病毒核酸检测引物由国家CDC提供，采用lit-PCR方法检测。结果该病例从美国回国，主要临床表现为发热，头痛，咳嗽，咽痛，鼻塞，少量流涕，全身不适，最高体温38．8℃，咽充血，扁桃体I度肿大、无脓点，双肺（－）。血常规：WBC：7．9×10^-9／L；N：5．5×10^-9／L；L：19．5％。胸部X线检查：双肺纹理较多，心影增大，咽拭子甲型H1N1流感病毒RT-PCR检测阳性，从咽拭子标本中分离出甲型H1N1流感病毒。患者恢复出院，接触者中无二代病例发生。结论患者的流行病学史和临床表现及实验室检查为确诊依据，适当处置得以痊愈，密切接触者未发病，可不必大范围预防性服药。

Discovery and Disposal of First Case of Influenza A (H1N1) Virus Infection in Mainland, China

Objective To summarize the experience of prevention and control of type A influenza H1N1 and to provide a scientific basis for dealing with similar epidemic situation in the future through China's first case of H1N1 influenza in mainland. Methods Control measures were made through clinical medical history, epide-miological investigation from CDC of different levels' and the diagnostic criteria, discharge criteria, and guidelines issued by Ministry of Public Health. H1N1 influenza virus nucleic acid primers were provided by China CDC, and the virus detection was made by using RT-PCR method. Results The main clinical manifes-tations of the patient, a returned student from USA, were fever, headache, cough, pharyngodynia, stuffy nose, a small amount of rhinorrhea, general malaise and other symptoms. Physical examination: 38. 8℃ (max BT), pharyngeal hyperemia, swollen tonsil Ⅰ degrees, no pus points, lungs (-). Routine blood test: WBC: 7.9×10-9/ L, N: 5.5×10-9/ L, L: 19. 5%. Chest X-ray examination: more double lung markings, increased heart shadow. Seasonal A / influ-enza B virus detection (colloidal gold method) were negative. H1N1 influenza virus was detected and isolated from throat swab by RT-PCR . After 7 days regular treatment, the patiend recovered and discharged. No second generation case occurred among close contacts. Conclusion Afferent cases would be more and more. Surveillance spots in hospitals should work efficiently and medical personnel should be trained. The scope of the search to suspected cases and influenza-like cases will be expanded. To strengthen the pathogenic monitoring and knowledge propaganda is essential.