目的确定人感染H7N9禽流感疫情,查明感染来源,以便采取相应措施控制疫情,为今后预防控制工作提供科学依据。方法对河南省开封市1例不明原因肺炎病例进行现场流行病学调查,同时采集患者咽拭子,采用荧光定量PCR方法进行流感病毒核酸检测,包括甲型、H1亚型、H3亚型、H5亚型、H7亚型和N9亚型。根据现场流行病学调查和实验室检测结果对该病例进行诊断和分析。结果该患者厨师职业,病初表现为流感样症状,并伴有胸闷,病情持续性加重,临床诊断为重症肺炎、急性呼吸窘迫综合征,不排除人感染H7N9禽流感病毒的可能。患者咽拭标本禽流感病毒(H7N9)核酸阳性。患者发病前未接触过类似病人,但接触过屠宰的禽类。所有密切接触者经医学观察8 d均未出现类似症状。结论该病例确诊为开封市首例人感染H7N9禽流感病例,未发现人传人的现象。 Objective To determine the human infection of H7N9 bird flu and identify the source of infection in order to take appropriate measures to control the outbreak and provide a scientific basis for future prevention and control. Methods A case of pneumonia of unexplained pneumonia was investigated in Kaifeng, Henan province. Throat swabs were also collected. Fluorescent quantitative PCR was used to detect influenza virus nucleic acid, including type A, H1 subtype, H3 subtype, H5 Subtype, H7 subtype and N9 subtype. The case was diagnosed and analyzed according to the field epidemiological investigation and laboratory test results. Results The patient chef occupation, early flu showed flu-like symptoms, accompanied by chest tightness, the disease continued to aggravate, clinical diagnosis of severe pneumonia, acute respiratory distress syndrome, does not rule out the possibility of human infection with H7N9 bird flu virus. Swallowing samples of patients with bird flu virus (H7N9) nucleic acid positive. Before the onset of the patient did not come into contact with a similar patient, but contact with slaughtered birds. All close contacts by medical observation 8 d did not appear similar symptoms. Conclusions This case was diagnosed as the first human case of H7N9 bird flu in Kaifeng City. No human-to-human transmission was found.