| 袁俊,狄飚,马晓薇,刘建平,陈艺韵,李魁彪,刘于飞,肖新才,蔡文锋,刘艳慧,杨智聪,王鸣.广州市人感染H7N9禽流感快速风险评估[J].中华流行病学杂志,2013,34(5):488-490 |
| 广州市人感染H7N9禽流感快速风险评估 |
| Risk evaluation on H7N9 avian influenza in Guangzhou，China |
| 收稿日期:2013-04-12 出版日期:2014-09-17 |
| DOI：10.3760/cma.j.issn.0254-6450.2014.02.017 |
| 中文关键词: H7N9禽流感 监测 风险评估 |
| 英文关键词: HTN9 avian influenza Surveillance Risk evaluation |
| 基金项目:国家科技重大专项(2012ZXl0004213—005);广州市医药卫生科技重点项目(201102A212006) |
| 作者 | 单位 | E-mail | | 袁俊 | 中山大学公共卫生学院 | | | 狄飚 | 广州市疾病预防控制中心, 510440 | | | 马晓薇 | 广州市疾病预防控制中心, 510440 | | | 刘建平 | 广州市疾病预防控制中心, 510440 | | | 陈艺韵 | 广州市疾病预防控制中心, 510440 | | | 李魁彪 | 广州市疾病预防控制中心, 510440 | | | 刘于飞 | 广州市疾病预防控制中心, 510440 | | | 肖新才 | 广州市疾病预防控制中心, 510440 | | | 蔡文锋 | 广州市疾病预防控制中心, 510440 | | | 刘艳慧 | 中山大学公共卫生学院 | | | 杨智聪 | 广州市疾病预防控制中心, 510440 | | | 王鸣 | 广州市疾病预防控制中心, 510440 | wangming@gzcdc．org．Cn |
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| 中文摘要: |
| 目的 了解广州市H7N9禽流感疫情并开展快速风险监测评估，为做好应急准备提供依据。方法 随机抽检活禽市场禽类和外环境，并调查活禽市场档口及从业人员防护情况。对野鸟(候鸟)栖息地鸟粪进行采样和访谈工作人员。整理分析不明原因肺炎监测系统数据和开展重症肺炎监测。采用RT-PCR方法检测标本H7N9亚型及H5和H9亚型禽流感病毒核酸。结果 共采集广州市12个区(县)13家活禽市场49个档口相关标本300份，均未检出H7N9禽流感病毒。1份砧板拭子检出H5亚型核酸阳性，阳性率为0．33％；4份标本(鸡笼、鸭笼、砧板、鸽笼)检出H9亚型核酸阳性，阳性率为1．33％。近1个月未发现病、死禽(鸟)和出现流感样症状的从业人员。21．2％(7／33)档口销售活禽未分“三间式”(售卖、屠宰、存栏)；10．3％(4／39)的档口>4 d才清洁笼具；现场宰杀禽类时仅3．7％(2／54)从业人员戴口罩，40．7％(22／54)戴手套。102份鸟粪采样均未检出H7N9禽流感病毒核酸。疾病监测系统近2个月未发现不明原因肺炎病例。4月3—17日全市共上报重症肺炎病例26例，H7N9禽流感病毒检测均阴性。结论 根据禽类环境标本实验室检测、人群不明原因肺炎监测和重症肺炎排查，以及市场相关人员防护水平等调查结果，判断广州市于4月初暂无H7N9禽流感疫情，但由于活禽市场对禽流感防控措施和从业人员防范意识不足，仍存在出现病例的风险。 |
| 英文摘要: |
| Objective We conducted both quick surveillance and evaluation programs within one week after the novel H7N9 influenza cases had been released by the Ministry of Health(MOH)，to get the basic information on H7N9 virus in Guangzhou．Methods We sampled live birds from food markets and the natural habitat of birds to detect H7N9．H5 and H9 viruses．We interviewed workers from both markets and natural habitats．We also reviewed records on pneumonia patients with unknown causes from the surveillance system．to find clues related to the identification of severe pneumonia． Results We sampled 300 specimens行om 49 stalls in 1 3 food markets and a natural habitat but none showed H7N9 positive result．A chopping block was detected positive of carting H5 avian influenza virus，while another 4 specimens including a chicken cage，a duck cage，a chopping block and a pigeon cage were detected positive of carrying H9 avian influenza virus．In the past month．no sick．dead birds or 1LI cases among the workers were discovered．2 1．2％(7／33)of the stalls did not follow the set regulations for prevention．10．3％(4／39)ofthe stalls had the cages cleaned，4 days after the inspection． 3．7％(2／54)of the workers wore masks and 40．7％(22154)of them wore gloves during the slaughtering process．102 bird feces specimens were tested negative on H7N9 virus．No pneumonia cases wim unknown reason were identified．From April 3rdto l7th．we found 26 severe pneumonia cases but with negafive results on influenza A(H7N9)．Conclusion According to the data and information from 1) lab tests．2)pneumonia cases with uflknown reasons under the surveillance system．3)the identification of severe pneumonia cases，and 4)preventive measures and actions taken by the workers，we inferred that no H7N9 virus or related cases were found prior to April in Guangzhou．However．the risk of H7N9 pidemic does exist because of the following reasons：1)improper market management process，2)negligent behavior of the workers and 3)potential trend of the national situation，suggesting strategies related to poultry markets management，health education and preventive measures against the avian influenza need to be strengthened． |
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