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目的分析2013~2015年河南省人感染H7N9禽流感确诊病例的流行病学和临床特征,为该病的监测与防控提供理论依据。方法采用流行病学个案调查与描述流行病学相结合方法收集分析人感染H7N9禽流感病例资料,采集病例、密接标本进行实验室检测。结果河南省共报告4例人感染H7N9禽流感确诊病例,3例治愈,1例死亡;病例报告集中在2013年4月份;病例分布在3个地市的4个县区;年龄中位数为46.5岁,均为男性;3例病例发病前有明确禽类接触史,42例密切接触者均未发生感染。病例发病到首诊中位时间为1天,发病到住院中位时间为4天,发病到确诊中位时间为9天,发病到使用抗病毒药物时间为4天,病程中位数为22天;死亡病例存在大年龄、基础疾病和郭亮烟酒史。结论河南省人感染H7N9禽流感疫情时间集中,地区分散,与禽类的密切接触是主要的感染来源,未发现人际间传播。临床主要表现为重症肺炎,有基础疾病的老年人是高危人群。
Objective To analyze the epidemiological and clinical features of confirmed cases of H7N9 bird flu from 2013 to 2015 in Henan Province and provide theoretical basis for monitoring and preventing this disease. Methods A case-by-case survey of epidemiology and a descriptive epidemiology method were used to collect and analyze cases of human H7N9 avian influenza infection. Samples were collected and closely matched for laboratory testing. Results A total of 4 confirmed cases of H7N9 bird flu were reported in Henan Province, 3 were cured and 1 died. The case reports were concentrated in April 2013; the cases were located in 4 counties of 3 cities; the median age was 46.5 years old, all male; 3 cases before the onset of a clear history of bird exposure, 42 cases of close contacts were not infected. The median time to first visit was 1 day. The median time to hospitalization was 4 days. The median time to diagnosis was 9 days. The time to onset of antiviral use was 4 days. The median duration of illness was 22 days ; Death cases exist in older age, basic diseases and Guo Liang alcohol history. Conclusion The epidemic situation of H7N9 bird flu in Henan Province was concentrated and dispersed in time. Close contact with poultry was the main source of infection and no interpersonal transmission was found. The main clinical manifestations of severe pneumonia, the elderly with underlying diseases are at high risk.