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目的分析深圳龙华新区2013-2015年人感染H7N9禽流感病例流行病学特征及相关监测结果,为合理防控人感染H7N9疫情提供科学依据。方法收集深圳龙华新区2013-2015年间报告的人感染H7N9病例信息及相关监测信息进行描述性和分析性研究。结果 2013-2015年深圳龙华新区共报告人感染H7N9禽流感病例5例,死亡1例。患者从发病至确诊中位数时间为7 d,从发病至发展为肺炎的中位数时间为3.5 d,从发病到使用达菲抗病毒治疗的中位数时间为4 d,患者发病前均有活禽市场暴露史;2013-2015年深圳龙华新区监测的626份活禽市场外环境样品中,检测出H7亚型禽流感病毒阳性117份,阳性率18.69%,其中与患者有流行病学关联活禽市场H7亚型禽流感病毒阳性率达31.43%;禁止活禽交易后,禽肉销售市场外环境H7亚型禽流感病毒阳性率显著下降(χ2=13.52,P<0.001)。结论活禽市场暴露及活禽市场污染源的存在是导致人感染H7N9禽流感发病的主要风险因素,禁止活禽交易能有效减少禽肉综合市场外环境H7亚型禽流感病毒的感染。
Objective To analyze the epidemiological characteristics of H7N9 bird flu in Longhua New District of Shenzhen from 2013 to 2015 and related monitoring results so as to provide a scientific basis for the prevention and control of H7N9 human infection. Methods A descriptive and analytical study was conducted to collect information on H7N9 cases and related surveillance data from 2013-2015 in Longhua New District, Shenzhen. Results In 2013-2015, Longhua New District of Shenzhen reported 5 cases of H7N9 bird flu and 1 death. The median time from onset to diagnosis was 7 days. The median time from onset to development of pneumonia was 3.5 days. The median time from onset to the use of Tamiflu antiviral therapy was 4 days. Before the onset of disease, There was a history of exposure in the live poultry market. Of the 626 live poultry market environmental samples monitored by Longhua New District of Shenzhen in 2013-2015, 117 were positive for the H7 subtype of avian influenza virus, the positive rate of which was 18.69%. Among them, epidemiology The positive rate of H7 subtype avian influenza virus was 31.43% in the related live poultry market. The positive rate of H7 subtype avian influenza virus in the external environment of poultry sales market was significantly decreased after the live poultry trade was banned (χ2 = 13.52, P <0.001). Conclusion The exposure of live poultry market and the existence of pollution sources in live poultry market are the major risk factors leading to human infection with H7N9 bird flu. Prohibition of live poultry transactions can effectively reduce the outbreak of H7 subtype avian influenza virus in the poultry general market.