寿钧, 周晓红, 何玉芳, 席胜军, 商晓春, 朱建慧, 王峥, 张睿, 胡薇薇, 黄巍, 赵琪, 帅慧群, 吕鑫. 杭州市下城区4例人感染H7N9禽流感病例的临床与流行病学特征分析[J]. 疾病监测, 2013, 28(8): 657-659. DOI: 10.3784/j.issn.1003-9961.2013.8.015
引用本文: 寿钧, 周晓红, 何玉芳, 席胜军, 商晓春, 朱建慧, 王峥, 张睿, 胡薇薇, 黄巍, 赵琪, 帅慧群, 吕鑫. 杭州市下城区4例人感染H7N9禽流感病例的临床与流行病学特征分析[J]. 疾病监测, 2013, 28(8): 657-659. DOI: 10.3784/j.issn.1003-9961.2013.8.015
SHOU Jun, ZHOU Xiao-hong, HE Yu-fang, XI Sheng-jun, SHANG Xiao-chun, ZHU Jian-hui, WANG Zheng, ZHANG Rui, HU Wei-wei, HUANG Wei, ZHAO Qi, SHUAI Hui-qun, LYU Xin. Clinical and epidemiological characteristics of 4 cases of human infection with avian influenza A (H7N9) virus in Xiacheng district of Hangzhou, Zhejiang[J]. Disease Surveillance, 2013, 28(8): 657-659. DOI: 10.3784/j.issn.1003-9961.2013.8.015
Citation: SHOU Jun, ZHOU Xiao-hong, HE Yu-fang, XI Sheng-jun, SHANG Xiao-chun, ZHU Jian-hui, WANG Zheng, ZHANG Rui, HU Wei-wei, HUANG Wei, ZHAO Qi, SHUAI Hui-qun, LYU Xin. Clinical and epidemiological characteristics of 4 cases of human infection with avian influenza A (H7N9) virus in Xiacheng district of Hangzhou, Zhejiang[J]. Disease Surveillance, 2013, 28(8): 657-659. DOI: 10.3784/j.issn.1003-9961.2013.8.015

杭州市下城区4例人感染H7N9禽流感病例的临床与流行病学特征分析

Clinical and epidemiological characteristics of 4 cases of human infection with avian influenza A (H7N9) virus in Xiacheng district of Hangzhou, Zhejiang

  • 摘要: 目的 对杭州市下城区2013年确诊报告的4 例人感染H7N9禽流感病例进行临床和流行病学分析, 为进一步科学防控人禽流感提供依据。 方法 对确诊病例和病例的密切接触者进行个案调查, 采用荧光双标记探针反转录-聚合酶链反应检测H7N9禽流感病毒。 对病例的呼吸道标本进行人感染H7N9禽流感病毒核酸检测。 结果 4例病例表现为重症肺炎并呈进行性加重, 发病至首次就诊平均时间为2 d, 首次住院为5 d, 确诊时间为7 d。4病例呈高度散发, 病例之间无流行病学关联, 发病时间均为春季,均有农贸市场暴露史。对病例采取隔离治疗、密切接触者进行医学观察、疫点终末消毒、农贸市场停止活禽交易等综合措施后, 疫情得到有效控制。 结论 4例人感染高H7N9禽流感病例发病与农贸市场暴露有关, 暂未发现人传人的证据。早期发现和救治患者是提高患者预后的关键, 要加强人感染H7N9禽流感疫情监测,及时科学处置疫情, 以控制疫情扩散。

     

    Abstract: Objective To understand the clinical and epidemiological characteristics of 4 confirmed cases of human infection with avian influenza A (H7N9) virus in Xiacheng district of Hangzhou, Zhejiang province, and provide evidence for the prevention and control of this kind of human infection. Methods All the confirmed cases and their close contacts were surveyed, and respiratory tract specimens were taken form the confirmed cases to detect the nucleic acid of H7N9 virus with real-time PCR. Results Four cases were diagnosed with severe and progressive pneumonia, The average interval between the onset of the disease and the first medical care seeking was 2 days, the average interval between the onset and the first hospitalization was 5 days and the average interval between the onset and the diagnosis was 7 days. The 4 cases were highly sporadic and no epidemiological links were found among them. All the cases occurred in spring and had the histories of farm produce market exposure, all the cases were isolated and treated, and all the close contacts received medical observation. Terminal disinfection was conducted and farm produce markets were closed. The epidemic was under control effectively. Conclusion The 4 cases of human infection with H7N9 were associated with farmer produce markets exposure, and no evidence of human to human transmission was found. Early detection and treatment of the cases infected with H7N9 are essential for the improvement of patients' prognosis, and it is necessary to strengthen the surveillance of H7N9 epidemic and conduct appropriate response to stop the spread of H7N9 virus.

     

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