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目的分析广州市首起人感染H7N9禽流感家庭聚集性疫情的流行病学特征,追溯感染来源,为预防控制人感染H7N9禽流感疫情提供科学依据。方法对病例、密切接触者和涉禽场所进行详细的流行病学调查,采集呼吸道标本和环境标本,采用RT-PCR方法检测H7N9病毒核酸。结果首例患者2014年1月3日发病,11日确诊为人感染H7N9禽流感病例,有活禽市场暴露史,病情危重;其密切接触者(女儿)14日发病,18日确诊为人感染H7N9禽流感病例,轻症病例,感染途径可能为活禽市场暴露或与患病父亲的密切接触。经积极处理和救治,疫情得到有效控制,两病例康复出院。结论此疫情为人感染H7N9禽流感家庭聚集性疫情,感染途径可能为活禽市场暴露和有限的人传人。及时开展流行病学调查和涉禽市场环境污染监测;加强病例及密切接触者管理、规范市场管理是控制人感染H7N9禽流感疫情的有效措施。
Objective To analyze the epidemiological characteristics of the first human aggression in H7N9 bird flu in Guangzhou and to trace the origin of the infection and provide a scientific basis for prevention and control of the human infection of H7N9 bird flu. Methods A detailed epidemiological investigation of cases, close contacts and wading places was conducted. Respiratory specimens and environmental samples were collected. The H7N9 virus nucleic acid was detected by RT-PCR. Results The first patient was diagnosed on January 3, 2014 and was diagnosed as H7N9 bird flu on the 11th. He had live poultry market exposure and was critically ill. Close contacts (daughters) developed on the 14th and were diagnosed as H7N9 birds on the 18th Flu cases, mild cases, routes of infection may be exposed to the live poultry market or close contact with the sick father. After active treatment and rescue, the outbreak was effectively controlled and both cases were discharged. Conclusions This outbreak is a familial epidemic in humans infected with H7N9 bird flu. The routes of infection may be exposure of the live poultry market and limited human transmission. Epidemiological investigation and monitoring of environmental pollution in the wading market are conducted in a timely manner. Strengthening the management of cases and close contacts and standardizing market management are effective measures to control the human infection of H7N9 bird flu.