文章编号：1004－9231（2013）09－0493－04·论著·作者简介：刘英（1971—），女，副主任医师，硕士。河南省首例人感染H7N9禽流感病例的流行病学调查刘英1，申运动2，李燕婷3（1．河南省洛阳市疾病预防控制中心，河南洛阳471000；2．河南省周口市疾病预防控制中心，河南周口466000；3．上海市疾病预防控制中心，上海200336）摘要：［目的］通过对1例人感染H7N9禽流感病毒患者的调查分析，为人感染H7N9禽流感的科学防控提供依据。［方法］采用流行病学调查方法，调查病例的发病经过、可能的感染来源、传播途径及暴露因素等，医学观察患者的密切接触者，同时对患者进行临床诊治、实验室检测。［结果］确诊1例人感染H7N9禽流感病毒，经救治后痊愈出院。患者有明确的活禽接触史，咽拭子检测H7N9禽流感病毒核酸阳性。患者的密切接触者中均未发现异常临床表现。通过扩大监测流感病例160例和职业人群858例，均未发现H7N9禽流感病毒核酸阳性。当地活禽交易市场鸡咽拭子标本检出2份H7N9禽流感病毒核酸阳性，阳性鸡来源于外省。［结论］活禽暴露是人感染H7N9禽流感病毒的关键风险因素，暂无证据人传人，未发现人群隐性感染和轻症病例。仍需开展扩大监测和流行病学调查，以完善对感染谱的认识。关键词：人感染H7N9禽流感病毒;流行病学;防控中图分类号：Ｒ511文献标志码：A Epidemiological investigation on the first case of human infection with H 7N 9avian influenza in Henan Province LIU Ying 1，SHEN Yun －dong 2，LI Yan －ting 3（1．Luoyang Center for Disease Control and Prevention ，Henan 471000，China ；2．Zhoukou Center for Disease Control and Prevention ，Henan 466000，China ；3．Shanghai Municipal Center for Disease Control and Prevention ，Shanghai 200336，China ）Abstract ：［Objective ］To investigate and analyze the first case of human infection with highly pathogenic avian influenza virus （H7N9）so as to provide scientific basis for control of avian influenza infec-tion in humans．［Methods ］Epidemiological survey was carried out including the process of morbidity ，possible infection source ，transmission route and risk factors ，etc．Strict observation was made on close con-tacts of the patient．Meanwhile the patient underwent clinical diagnosis ，treatment and laboratory tests．［Ｒesults ］The patient was confirmed to be infected with highly pathogenic human avian influenza H7N9virus as ascertained by expert group of ministry of health ，and was cured and discharged．The patient had definate contact with live poultry ，and using H7N9pharyngeal swab through laboratory tests ，avian influenza virus nucleic acid showed positivity results．No abnormalities were found in clinical manifestations in close contacts of the patient．By expanding surveillance on 160cases of influenza-likeillness （ILI ）and 858cases of professional groups ，the samples were not found to be H7N9positive．However ，on local live poultry market ，two chicken pharyngeal swab specimens were detected to be H7N9positive．Positive chickens were from other provinces．［Conclusion ］History of live poultry exposure is believed to be the key risk fac-tors in infection with H7N9virus．So far there has been no evidence of human-to-human transmission．There has not been subclinical infection or mild cases found in crowd．However ，there is the need to expand monitoring and epidemiological investigation so as to improve the understanding of the disease．Key words ：Human infection with H7N9avian influenza virus ；Epidemiological investigation ；Prevention and control2013年3月底，上海市、安徽省先后发生3例不明原因重症肺炎病例，患者均曾有活禽鸟接触史，经病原体分离鉴定后，于3月31日确诊为人感染新型甲型H7N9禽流感病毒（avian influenza virus ，AIV ）·394·2013年第25卷第9期2013，Vol．25No．9上海预防医学Shanghai Journal of Preventive Medicine
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