高原地区青海省2017-2018年度流感样病例流行病学特征分析

赵金华; 石燕; 曹海兰; 李永红; 李红; 卢囡囡; 徐莉立

doi:10.16462/j.cnki.zhjbkz.2019.01.009

高原地区青海省2017-2018年度流感样病例流行病学特征分析

doi: 10.16462/j.cnki.zhjbkz.2019.01.009

810007 西宁, 青海省疾病预防控制中心传染病预防控制所

基金项目:

青海省应用基础研究和自然科学基金项目 2019-zj-7046

详细信息

通讯作者:
徐莉立, E-mail: qhcdcxull@126.com

中图分类号: R181.22
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出版历程
- 收稿日期: 2018-06-14
- 修回日期: 2018-10-17
- 刊出日期: 2019-01-10

Surveillance analysis on influenza-like illness from 2017 to 2018 in the plateau of Qinghai Province

Institute of Infectious Disease Prevention and Control, Qinghai Center for Disease Control and Prevention, Xining 810007, China

Funds:

The Project of Applied Basic Research and Natural Science Foundation of Qinghai Province 2019-zj-7046

More Information

Corresponding author: XU Li-li, E-mail: qhcdcxull@126.com

摘要

摘要: 目的分析高原地区青海省2017年第14周~2018年第13周（2017年4月3日~2018年4月1日），流感监测系统中流感样病例监测结果，掌握流感流行实时动态，为科学防控流感提供依据。方法收集分析青海省2017-2018年度流感样病例流行病学及病原学特征。结果 2017年第14周~2018年第13周青海省共报告流感样病例26 086例，门急诊病例总数就诊百分比为2.95%（26 086/884 529）；5岁以下儿童占总报告病例的71.51%（18 655/26 086）；共对11 391份标本进行实时荧光定量聚合酶链式反应检测，阳性1 991份，阳性率为17.48%（1 991/11 391）；前期以H3、H1为主，中期以H3、H1和B型混合出现，后期以B型为主，其中BY为优势毒株；病毒核酸阳性检出率在年龄（χ²=108.59，P<0.001）和时间（χ²=1629.13，P<0.001）上的差异均有统计学意义（均有P<0.05）；但在性别上的差异无统计学意义（χ²=5.33，P=0.021）；流感样病例数及流感样病例就诊百分比与流感病毒核酸阳性率呈相关（Pearson相关系数分别为0.896和0.699，均有P<0.001）。结论 16家哨点医院流感样病例及就诊百分比能准确体现青海省流感病毒实际活动水平，报告病例以5岁以下儿童为主；优势毒株交替出现，病毒高峰在12月中旬~次年1月中旬；要加强流行季节5岁以下组人群及发热诊室中流感样病例的监测，强化0岁组中流感样病例标本采集；集体机构要重点疫情防控流感。
- 高原地区 /
- 流感样病例 /
- 门急诊病例总数就诊百分比 /
- 流行病学特征
Abstract: Objective To analyze the surveillance results of influenza-like illness (ILI) and investigate the prevalent trend of influenza from 14th week 2017 to 13th week 2018 (April 3, 2017-April 1, 2018) in Qinghai Province so as to provide the scientific basis for the development of prevention and control measures. Methods The epidemiological and pathogenic characteristics of influenza-like cases in qinghai province from 14th week 2017 to 13th week 2018 were collected and analyzed. Results ILI mainly occurred in winter and spring from 14th week 2017 to 13th week 2018, 26 086 ILI cases reported in total, accounting for 2.95% (26 086/884 529) of total number of outpatients and emergency cases; including 18 655 cases under 5 years old, accounting for 71.51%; 1 991 cases were detected with positive by real -time RT PCR with the positive rate of 17.48% (1 991/11 391), In the early stage, H3 and H1 were the predominate strains and the middle period was mixed with H3, H1 and B, and the latter was dominated by type B. Positive rates of influenza virus testing had no statistical differences in different gender (χ²=5.33, P=0.021), while with statistical differences in different age and time (χ²=108.59, P<0.001; χ²=1 629.13, P<0.001). Number of ILI cases and the percentage in the outpatients was significantly related with influenza virus positive rates (Pearson correlation coefficient was 0.896 and 0.699, respectively, P<0.001). Conclusions Influenza-like cases at sentinel hospital of Qinghai Province can accurately reflect actual activity level. The peak of positive detection of influenza samples in Qinghai province from 14 weeks 2017 to 13 weeks 2018 season was from mid-December to mid-January. The dominant strain of influenza viruses alternated, and the majority of the affected population is mainly in children under 5 years old. In the future, we should strengthen monitoring works in epidemic season, from October to March of next year and focus on the children under 5 years old and the fever clinic. The collection of samples of influenza-like cases in the 0-year-old group should be strengthened, and collective organizations should focus on influenza prevention and control.
- The Plateau area /
- Influenza like illness /
- Total number of outpatient and emergency cases /
- Epidemiological characteristics

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图 1 2017-2018年度及前3年流感样病例就诊百分比时间分布

Figure 1. The time distribution of the percentage of influenza-like cases from 2017 to 2018 and the previous three years

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图 2 2017-2018年度流感病例核酸阳性标本时间分布

Figure 2. The time distribution of nucleic acid positive samples of influenza cases from 2017 to 2018

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图 3 2017-2018年度流感病毒核酸阳性标本周分布

Figure 3. Distribution of nucleic acid positive samples of influenza virus from 2017 to 2018

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图 4 2017-2018年度青海省流感样病例数与流感病毒核酸阳性率散点图

Figure 4. Scatter diagram of the number of influenza-like cases and the positive rate of influenza virus nucleic acid in Qinghai Province from 2017 to 2018

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图 5 2017-2018年度青海省ILI%与流感病毒核酸阳性率散点图

Figure 5. Scatter diagram from 2017 to 2018 ILI% and influenza virus nucleic acid positive rate in Qinghai Province

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表 1 2017-2018年度青海省流感不同年龄组核酸检测结果[n(%)]

Table 1. Nucleic acid test results of different age groups about influenza of Qinghai Province from 2017 to 2018[n(%)]

年龄组(岁)	检测数	流感病毒核酸检出阳性情况	亚型分布(阳性率)
年龄组(岁)	检测数	流感病毒核酸检出阳性情况	甲型H3N2	甲型H1N1	BY	BV
0~	5 592	826(14.77)	338(6.04)	247(4.42)	136(2.43)	105(1.88)
5~	2 355	540(22.93)	158(6.71)	152(6.45)	110(4.67)	120(5.10)
15~	790	195(24.68)	79(10.00)	56(7.09)	43(5.44)	17(2.15)
25~	1 994	327(16.40)	146(7.32)	65(3.26)	90(4.51)	26(1.30)
≥60	660	103(15.61)	48(7.27)	10(1.52)	34(5.15)	11(1.67)
合计	11 391	1 991(17.48)	769(6.75)	530(4.65)	413(3.63)	279(2.45)

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表 2 2017-2018年度青海省不同季度阳性检出情况

Table 2. Positive test results of different quarters of Qinghai Province from 2017 to 2018

季节(月份)	检测数	阳性标本	核酸阳性检出率(%)	χ²值	P值
春季(3~5)	2 353	82	3.48
夏季(6~8)	1 504	30	1.99
秋季(9~11)	2 709	237	8.75
冬季(12~2)	4 825	1642	34.03	1 629.13	0.001
合计	11 391	1 991	17.48

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