Epidemiological characteristics of an outbreak of mixed infections of respiratory viruses in Zhangjiakou of Heibei, in 2022
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摘要:
目的 探讨2022年河北省张家口市某工厂一起由腺病毒55型、乙型流感病毒、甲型流感病毒、副流感病毒3型混合感染暴发疫情的流行病学特征,探究流行的危险因素,为疫情早期预警和防控提供科学依据。 方法 对该厂区可能受疫情影响的所有人员进行现场流行病学调查,采集咽拭子进行病原体核酸筛查,并定期开展多轮病原筛查,持续监测病原结果。 结果 经实验室检测确认该起疫情由腺病毒55型(感染273例)、乙型流感病毒(感染225例)、副流感病毒3型(感染40例)、甲型流感病毒(感染9例)混合感染引起,共导致547人感染。 疫情主要流行于青年男性工人群体,吸烟者感染率高于非吸烟者。 乙型流感病毒感染者的症状最为明显,发热和全身症状比例较高。 结论 人群密集的工厂内吸烟的青年工人群体为4类呼吸道病毒的主要感染对象。 应重点关注人群密集场所的健康教育、症状监测和病原筛查,控制呼吸道传染病流行。 Abstract:Objective To understand the epidemiological characteristics of an outbreak of mixed infections of human adenovirus type 55, influenza B virus, influenza A virus and parainfluenza virus type 3 in a factory in Zhangjiakou, Hebei province, in 2022, identify the risk factors and provide scientific evidence for the early warning, surveillance and control of epidemic. Methods Field epidemiological survey was conducted in all the people who might be affected by the outbreak in the factory. Throat swabs were collected from them for pathogen nucleic acid screening and multi-round regular pathogen screening were conducted for dynamic etiological surveillance. Results A total of 547 cases of infections of respiratory viruses were reported in this outbreak, in which laboratory test confirmed 273 cases of human adenovirus 55 infection, 225 cases of influenza B virus infection, 40 cases of parainfluenza virus type 3 infection and 9 cases of influenza A virus infection. The cases mainly occurred in young male workers and the infection rate was higher in smokers than in non-smokers. The symptoms of influenza B virus infection were most obvious with higher proportions of fever and systemic symptoms. Conclusion Young workers who smoked in this factory were the main population affected by the infections of the four respiratory viruses. Attention should be paid to health education, symptom monitoring and pathogen screening in the places with mass people to control the epidemic of respiratory diseases. -
Key words:
- Influenza B virus /
- Human adenovirus /
- Parainfluenza virus /
- Influenza A virus /
- Outbreak
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表 1 2022年河北省张家口市某厂区急性呼吸道病毒感染区域分布
Table 1. Area specific distribution of infection rates of respiratory viruses in a factory of Zhangjiakou, Heibei, in 2022
主要活动场所 人数 腺病毒55型 乙型流感病毒 副流感病毒3型 甲型流感病毒 1车间 832 81 (9.74) 116 (13.94) 3 (0.36) 3 (0.36) 2车间 874 51 (5.83) 87 (9.95) 14 (1.60) 1 (0.11) 3车间 858 79 (9.21) 10 (1.17) 3 (0.35) 3 (0.35) 4车间 882 40 (4.54) 11 (1.25) 14 (1.59) 0 (0.00) 后勤宿舍 87 22 (25.29) 1 (1.15) 6 (6.90) 2 (2.30) 保安宿舍 55 0 (0.00) 0 (0.00) 0 (0.00) 0 (0.00) 办公大楼 186 0 (0.00) 0 (0.00) 0 (0.00) 0 (0.00) χ2值 – – – – – P值 <0.001 <0.001 <0.001 0.493 注:括号外数据为阳性例数(例),括号内数据为感染率(%);–. 使用Fisher精确概率法计算 表 2 2022年河北省张家口市某厂区急性呼吸道病毒感染率人群分布特征
Table 2. Population distribution of infection rates of respiratory viruses in a factory of Zhangjiakou, Heibei, in 2022
特征 腺病毒55型(n=273) 乙型流感病毒(n=225) 副流感病毒3型(n=40) 甲型流感病毒(n=9) 年龄组(岁) <20 (n=709) 63 (8.89) 55 (7.76) 5 (0.71) 1 (0.14) 20~ (n=2 715) 205 (7.55) 165 (6.08) 35 (1.29) 7 (0.26) 30~ (n=200) 4 (2.00) 5 (2.50) 0 (0.00) 1 (0.50) ≥40 (n=150) 1 (0.67) 0 (0.00) 0 (0.00) 0 (0.00) χ2值 21.09 17.93 – – P值 <0.001 <0.001 0.154 0.675 人员类别 车间管理(n=436) 23 (5.26) 16 (3.66) 5 (1.14) 4 (0.92) 车间工人(n=3 057) 249 (8.14) 206 (6.74) 35 (1.14) 3 (0.10) 厂区管理(n=96) 0 (0.00) 3 (3.13) 0 (0.00) 1 (1.04) 后勤人员(n=185) 1 (0.56) 0 (0.00) 0 (0.00) 1 (0.54) χ2值 26.11 20.48 – – P值 <0.001 <0.001 0.488 0.004 是否吸烟 不吸烟(n=2 866) 45 (1.57) 31 (1.08) 6 (0.21) 0 (0.00) 吸烟(n=908) 228 (25.11) 194 (21.37) 34 (3.74) 9 (0.99) χ2值 565.90 502.43 78.84 – P值 <0.001 <0.001 <0.001 <0.001 注:括号外数据为阳性例数(例),括号内数据为感染率(%);–. 使用Fisher精确概率法计算 表 3 2022年河北省张家口市某厂区急性呼吸道病毒感染症状发生率
Table 3. Symptoms of acute respiratory infections in a factory of Zhangjiakou, Heibei, in 2022
症状 腺病毒55型(n=166) 乙型流感病毒(n=140) 副流感病毒3型(n=31) 甲型流感病毒(n=6) P值 发热 18(10.84) 36(25.71) 2(6.45) 3(50.00) <0.001 畏寒 16(9.64) 32(22.86) 0(0.00) 2(33.33) <0.001 乏力 17(10.24) 21(15.00) 1(3.23) 3(50.00) 0.008 咳嗽 59(35.54) 60(42.86) 7(22.58) 2(33.33) 0.173 咽痛 60(36.14) 76(54.29) 5(16.13) 1(16.67) <0.001 鼻塞 66(39.76) 78(55.71) 3(9.68) 1(16.67) <0.001 流涕 81(48.80) 92(65.71) 5(16.13) 0(0.00) <0.001 胸闷 30(18.07) 35(25.00) 0(0.00) 0(0.00) 0.148 呼吸困难 2(1.20) 2(1.43) 0(0.00) 1(16.67) 0.914 头痛 2(1.20) 14(10.00) 1(3.23) 2(33.33) 0.003 肌肉酸痛 7(4.22) 24(17.14) 0(0.00) 3(50.00) 0.002 恶心 2(1.20) 4(2.86) 0(0.00) 0(0.00) 0.584 呕吐 5(3.01) 2(1.43) 0(0.00) 0(0.00) 0.611 结膜炎 0(0.00) 0(0.00) 0(0.00) 0(0.00) – 腹泻 7(4.22) 2(1.43) 1(3.23) 1(16.67) 0.140 肺炎 0(0.00) 0(0.00) 0(0.00) 0(0.00) – 哮喘 0(0.00) 0(0.00) 0(0.00) 0(0.00) – 注:括号外数据为阳性例数(例),括号内数据为发生率(%);–. 无数据 -
[1] Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013[J]. Lancet, 2015, 386(9995): 743–800. DOI: 10.1016/S0140−6736(15)60692−4. [2] Li ZJ, Zhang HY, Ren LL, et al. Etiological and epidemiological features of acute respiratory infections in China[J]. Nat Commun, 2021, 12(1): 5026. DOI: 10.1038/s41467−021−25120−6. [3] Krammer F, Smith GJD, Fouchier RAM, et al. Influenza[J]. Nat Rev Dis Primers, 2018, 4(1): 3. DOI: 10.1038/s41572−018−0002−y. [4] Mao NY, Ji YX, Xie ZD, et al. Human parainfluenza virus-associated respiratory tract infection among children and genetic analysis of HPIV-3 strains in Beijing, China[J]. PLoS One, 2012, 7(8): e43893. DOI: 10.1371/journal.pone.0043893. [5] Shi WF, Ke CW, Fang SS, et al. Co-circulation and persistence of multiple A/H3N2 influenza variants in China[J]. Emerg Microbes Infect, 2019, 8(1): 1157–1167. DOI: 10.1080/22221751.2019.1648183. [6] Yu HJ, Alonso WJ, Feng LZ, et al. Characterization of regional influenza seasonality patterns in China and implications for vaccination strategies: spatio-temporal modeling of surveillance data[J]. PLoS Med, 2013, 10(11): e1001552. DOI: 10.1371/journal.pmed.1001552. [7] Pscheidt VM, Gregianini TS, Martins LG, et al. Epidemiology of human adenovirus associated with respiratory infection in southern Brazil[J]. Rev Med Virol, 2021, 31(4): e2189. DOI: 10.1002/rmv.2189. [8] 吴殚, 胡广义, 张文增, 等. 2017-2019年北京市顺义区中小学校流行性感冒疫情特征分析[J]. 中国病毒病杂志,2021,11(3):172–175. DOI:10.16505/j.2095−0136.2021.0011.Wu D, Hu GY, Zhang WZ, et al. Epidemiological characteristics of influenza outbreaks in primary and secondary schools of Shunyi district of Beijing, 2017–2019[J]. Chin J Viral Dis, 2021, 11(3): 172–175. DOI: 10.16505/j.2095−0136.2021.0011. [9] 章保新, 简明, 袁桔华, 等. 基于文献的中国军队腺病毒感染流行特征分析[J]. 中国感染控制杂志,2021,20(3):198–204. DOI:10.12138/j.issn.1671−9638.20217216.Zhang BX, Jian M, Yuan JH, et al. Epidemiological characteristics of Human adenovirus infection in Chinese army: literature-based analysis[J]. Chin J Infect Control, 2021, 20(3): 198–204. DOI: 10.12138/j.issn.1671−9638.20217216. [10] GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet, 2020, 396(10258): 1204–1222. DOI: 10.1016/S0140−6736(20)30925−9. [11] de Wit E, Van Doremalen N, Falzarano D, et al. SARS and MERS: recent insights into emerging coronaviruses[J]. Nat Rev Microbiol, 2016, 14(8): 523–534. DOI: 10.1038/nrmicro.2016.81. [12] 佘敏, 高志丹, 曾浩, 等. 某部一起乙型流感疫情流行病学调查处置与启示[J]. 解放军预防医学杂志,2020,38(10):65–67. DOI: 10.13704/j.cnki.jyyx.2020.10.023.She M, Gao ZD, Zeng H, et al. Epidemiological investigation and implications of an influenza B epidemic in a camp[J]. J Prev Med Chin PLA, 2020, 38(10): 65–67. DOI: 10.13704/j.cnki.jyyx.2020.10.023. [13] 皇益英, 刘彬辉. 浙江省湖州市某学校一起人鼻病毒引起呼吸道感染暴发疫情调查[J]. 上海预防医学,2022,34(3):214–217. DOI: 10.19428/j.cnki.sjpm.2022.20942.Huang YY, Liu BH. Investigation on an outbreak of respiratory tract infection caused by human rhinovirus in a school in Huzhou city, Zhejiang province[J]. Shanghai J Prev Med, 2022, 34(3): 214–217. DOI: 10.19428/j.cnki.sjpm.2022.20942. [14] Lambert L, Culley FJ. Innate immunity to respiratory infection in early life[J]. Front Immunol, 2017, 8: 1570. DOI: 10.3389/fimmu.2017.01570. [15] Woodland DL, Hogan RJ, Zhong WM. Cellular immunity and memory to respiratory virus infections[J]. Immunol Res, 2001, 24(1): 53–67. DOI: 10.1385/IR:24:1:53. [16] Hogan RJ, Usherwood EJ, Zhong WM, et al. Activated antigen-specific CD8+ T cells persist in the lungs following recovery from respiratory virus infections[J]. J Immunol, 2001, 166(3): 1813–1822. DOI: 10.4049/jimmunol.166.3.1813. [17] Greenberg D, Givon-Lavi N, Broides A, et al. The contribution of smoking and exposure to tobacco smoke to Streptococcus pneumoniae and Haemophilus influenzae carriage in children and their mothers[J]. Clin Infect Dis, 2006, 42(7): 897–903. DOI: 10.1086/500935. [18] Bugova G, Janickova M, Uhliarova B, et al. Effect of passive smoking on bacterial colonisation of the upper airways and selected laboratory parameters in children[J]. Acta Otorhinolaryngol Ital, 2018, 38(5): 431–438. DOI: 10.14639/0392−100X−1573. [19] 丁晨曦, 艾乐乐, 韩一芳, 等. 某部一起呼吸道腺病毒暴发疫情的流行病学分析[J]. 解放军预防医学杂志,2019,37(3):7–8,11. DOI: 10.13704/j.cnki.jyyx.2019.03.003.Ding CX, Ai LL, Han YF, et al. Epidemiological analysis of an outbreak of respiratory adenovirus in a department[J]. J Prev Med Chin PLA, 2019, 37(3): 7–8,11. DOI: 10.13704/j.cnki.jyyx.2019.03.003. [20] Opatowski L, Baguelin M, Eggo RM. Influenza interaction with cocirculating pathogens and its impact on surveillance, pathogenesis, and epidemic profile: A key role for mathematical modelling[J]. PLoS Pathog, 2018, 14(2): e1006770. DOI: 10.1371/journal.ppat.1006770. [21] Li ZJ, Yu LJ, Zhang HY, et al. Broad impacts of coronavirus disease 2019 (COVID-19) pandemic on acute respiratory infections in China: an observational study[J]. Clin Infect Dis, 2022, 75(1): e1054–e1062. DOI: 10.1093/cid/ciab942. [22] Geng MJ, Zhang HY, Yu LJ, et al. Changes in notifiable infectious disease incidence in China during the COVID-19 pandemic[J]. Nat Commun, 2021, 12(1): 6923. DOI: 10.1038/s41467−021−27292−7. [23] Fang LQ, Zhang HY, Zhao H, et al. Meteorological conditions and nonpharmaceutical interventions jointly determined local transmissibility of COVID-19 in 41 Chinese cities: A retrospective observational study[J]. Lancet Reg Health West Pac, 2020, 2: 100020. DOI: 10.1016/j.lanwpc.2020.100020. -