陕西省首例人感染H7N9禽流感病例及聚集性疫情调查分析

目的 通过对陕西省首例人感染H7N9禽流感病例及聚集性疫情的流行病学的调查,了解病例感染的来源和危险因素,为今后类似疫情的防控工作提供依据。方法 对两例病例、家属、医护人员等进行流行病学调查,对两例病例的咽拭子进行核酸检测,对活禽市场等采集鸡笼、饮水环境等进行核酸检测,结合检测结果,分析此次疫情的流行病学特征和防控措施。结果 病例A发病前7 d有活禽暴露史,发病后未能及时确诊,病例死亡;病例B发病前无明确的活禽或活禽市场暴露史,4月22日出现低热症状,24日探望了病例A,5月2日病重后及时报告接触史,实验室确诊后,经积极救治,5月26日痊愈。结论 病例A的感染来源可能是活禽或活禽市场环境暴露,病例B感染来源可能是与病例A近距离接触,病例A与B传播方式为人传人的可能性较大。

Investigation and analysis of the first case of human infection with H7N9 avian influenza and aggregated epidemic in Shaanxi Province,China

We’ve done an epidemiological investigation of the first case of human infection with H7N9 avian influenza and its aggregated epidemic in Shaanxi Province in order to understand the source and potential dangers of this infection,which provided us the basis for prevention and control of similar epidemic situation. We analyzed the epidemiological characteristics and measures of prevention and control by the means of epidemiological investigation on the 2 infected people and their close contacts,such as their family and medical staff, and the comprehensive analysis of nucleic acid test result on patient’s throat swabs and environmental samples which included hencoops and drinking water collected in poultry markets. The results showed that the case A had died 7 days later after he contacted live poultry and he didn’t have timely diagnosis after being infected. However,the case B didn’t have clear contact history with live poultry before being attacked and he had a low fever on 22nd April and he visited case A on 24th April. On 2nd May, case B reported his contact history when he was in serious illness condition and he was cured on 4th May after being diagnosed and treated. After the investigation,we made a conclusion that the source of infection of the case A might be either live poultry environmental exposure or live poultry and the source of infection of the case B might be close contact with case A. There was much chance that the route of transmission between case A and case B was human-to-human transmission.