湖南省2005-2017年人感染禽流感流行病学特征分析

目的 对湖南省发现的所有人感染禽流感病例进行流行病学特征分析，为防控策略的制定和调整提供科学依据。方法 对疫情概况、病例三间分布和暴露史进行描述，并报道家庭聚集性病例。结果 湖南省已发现人感染H5N1病例6例，人感染H5N6病例4例，人感染H7N9病例99例，人感染H9N2病例6例。病例主要发生在11月至次年4月。H5N1病例分布在5个市州，H5N6病例分布在4个市州，H9N2病例分布在3个市州，H7N9病例分布在13个市州。4种亚型人感染禽流感在男性和女性中均有发生。H5N1、H5N6和H9N2病例年龄较小，H7N9病例以中老年为主。51.0%的病例为农民。95.5%的病例有禽类或禽类污染的环境暴露史。湖南省已发现H5N1、H5N6疑似家庭聚集性病例和H7N9确诊家庭聚集性疫情。结论 禽类和禽类环境是人感染禽流感病毒的主要来源，开展环境监测有利于疾病的预测预警。禽流感病毒存在有限非持续的人传人现象，密切监测病毒基因变化，对密切接触者实行医学观察，对于防止二代病例发生有重要意义。

Epidemiologic characteristics of human avian influenza in Hunan Province from 2005 to 2017

Analyze the epidemiologic characteristics of human avian influenza in Hunan Province from 2005 to 2017 in order to provide scientific evidences for making and modifying control strategies. Methods Describe the epidemic situation of human avian influenza in Hunan and the cases distribution and exposure history, including the family-clustered cases. Results Six H5N1 cases, four H5N6 cases, ninty-nine H7N9 cases and six H9N2 cases have been confirmed in Hunan. Most of the human avian influenza cases occurred between November and the following April. H5N1 cases were distributed in five cities, H5N6 cases were distributed in four cities, H9N2 cases were distributed in three cities, and H7N9 cases were distributed in thirteen cities. All of the four subtype human avian influenza has been found in male and female. The average age of H5N1, H5N6 and H9N2 cases was younger than H7N9. Fifty-one percents of the human avian influenza were farmers. 95.5% of the cases have been exposed to poultry or environments polluted by poultry. Suspected family-clustered H5N1 cases and H5N6 cases have occurred and family-clustered H7N9 cases have been confirmed in Hunan. Conclusions Poultry and environments polluted by poultry were the main infectious sources of human avian influenza, thus environmental surveillance was beneficial to disease forecast and precaution. Since the transmission of avian influenza virus among human were limited and non-sustainable, surveillance on virus gene's change and medical observation on close contacts were significant for preventing occurrence of the secondary cases.