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目的分析人感染H7N9禽流感病例的流行病学特征,评估活禽交易市场休市措施对疫情的影响。方法对广东省肇庆市怀集县人感染H7N9禽流感确诊病例临床表现和流行病学特征进行描述性分析,同时采用实时荧光定量反转录-聚合酶链反应(real time RT-PCR)对病例家庭禽类养殖环境、全县活禽交易市场休市前、休市后市场环境标本进行检测。结果怀集县共确诊人感染H7N9禽流感病例9例,无死亡病例。重症病例主要表现为重症肺炎,轻症病例以咳嗽、咽痛为主;分布在全县5个镇,年龄中位数为11岁(4~62岁)。全部病例均有明确的禽类接触史,4/9的病例有慢性基础性疾病;病例的164名密切接触者共有6人出现流感样症状,其中1人经确诊为人感染H7N9禽流感病例,考虑为同源暴露。休市前主城区H镇市场环境标本H7型阳性率为65.00%(52/80),休市后为3.49%(3/86);乡镇市场休市前为14.81%(12/81),休市后为0(0/111)。休市后全县人感染H7N9禽流感新发病例大幅度下降。结论 9例人感染H7N9禽流感病例以轻症病例为主,4~11岁年龄组人群多发,病例均有明确的禽类接触史。采取暂停市场活禽交易等综合防控措施能有效控制疫情。
Objective To analyze the epidemiological characteristics of human cases of avian influenza H7N9 infection and to evaluate the impact of the market closure measures of live poultry on the epidemic situation. Methods The clinical manifestations and epidemiological characteristics of human H7N9 bird flu in Huaiji County, Zhaoqing City, Guangdong Province were analyzed. The real-time quantitative RT-PCR Domestic poultry breeding environment, the county live poultry trading market before the market closed, the market environment after the test samples. Results A total of 9 cases of H7N9 bird flu were detected in Huaiji County without any deaths. Severe cases were mainly severe pneumonia, mild cases of cough, sore throat; distributed in the county five towns, the median age of 11 years (4 to 62 years old). In all cases, there was a clear history of bird contact, with 4/9 cases of chronic underlying disease; a total of 6 out of 164 close contacts had influenza-like symptoms, of which 1 was diagnosed as H7N9 bird flu, considered as Homologous exposure. The positive rate of H7 was 65.00% (52/80) in the market of H town in the main city before the suspension and 3.49% (3/86) after the market closed. The market of the township and town was 14.81% (12/81) before the market closed and 0 (0/111). After the closure of the county people infected with H7N9 new cases of bird flu dropped significantly. Conclusions Nine cases of human H7N9 bird flu were mainly mild cases, and the majority of cases occurred in 4-11-year-old age groups. All cases had a clear history of bird contact. To take a pause in the market of poultry transactions and other comprehensive prevention and control measures can effectively control the outbreak.