【摘要】 目的分析2010-2012年无锡市流感监测结果,掌握其流行规律,病毒型别及其活动水平,为防控流感提供科学依据。方法分析2010-2012年无锡市原有国家级监测哨点流感监测结果以及2012年县级流感监测结果。流感监测内容包括流行病学和病原学两方面,采集哨点医院部分ILI咽拭子标本,用实时荧光聚合酶链反应(RT-PCR)分子生物学方法和鸡胚或狗肾细胞(MDCK)培养方法进行病毒分离,采用血凝抑制实验对分离的流感毒株进行型别鉴定。结果 2010-2012年2所国家级哨点医院门诊就诊者共计1 354 671例,其中ILI 28 919例,占2.13%,ILI%每年出现冬春季和夏季两个流行高峰,70.30%的ILI集中在5岁以下年龄组,流感核酸阳性率与ILI%相关性无统计学意义(P>0.05),部分高峰月阳性率与ILI%略有偏移,或ILI%未见显著高峰值。2012年江阴市2家县级流感监测哨点医院流感毒株阳性率(72.73%)与ILI%(27.47%)均在30周达到高峰值,两者呈正相关(相关系数为0.738,P<0.01)。采集鼻咽拭子3 720份,检出流感病毒566株,阳性率为15.22%,其中A(H3)型、甲型H1N1型和B型分别占37.81%、11.66%和50.53%。15~24岁年龄组流感病毒阳性率及B型、甲型H1N1流感阳性率最高,60岁以上老人(H3)型阳性率最高。结论经过甲型H1N1流感大流行后,无锡市2010-2012年度流感处于季节性常态流行,每年ILI和病毒阳性率均有两个高峰,即冬春季和夏季;优势菌株之间的交替有一定规律;流感病毒活动与ILI之间有一定相关性,基层局部地区ILI监测数据灵敏度可能更高,ILI%与阳性率吻合度更高。更多还原

【Abstract】 Objective The study analyzed the results of influenza surveillance in Wuxi between 2010 and 2012 to determine the epidemic patterns, species of viruses, and the levels of virus activities, so to provide a scientific reference for the prevention and control of influenza epidemic. Methods Influenza surveillance results from the existing national sentinels in Wuxi City between 2010-2012 and from county sentinels in 2012 were analyzed. The influenza surveillance monitored patients with influenza-like illness and the etiology of the epidemic. A portion of the ILI throat swab specimens from the sentinel hospitals were collected; viruses in the specimens were isolated by real-time polymerase chain reaction(RT-PCR) and culturing Madin-Darby canine kidney(MDCK) cells, and the isolated influenza strains were genotyped by hemagglutination inhibition assay. Results A total of 1354671 patients visited the clinics at the two national sentinel hospitals between 2010 and 2012, including 28919 cases of ILI(2.13%). The ILI% peaked in winter/spring and in summer, and 70.30% of the ILI cases occurred in patients under the age of 5. The correlation between positive rate of influenza nucleic acids and ILI% was not statistically significant(P>0.05); during certain peak months, the positive rate and ILI% showed slight deviations or no peak value for ILI%. In 2012, positive rate of influenza strains(72.73%) and ILI%(27.47%) at two county sentinel hospitals in Jiangyin City peaked at the 30th week; and the two numbers were positively correlated(with a correlation coefficient of 0.738, P<0.01). Among the 3720 collected nasopharyngeal swabs, 566 strains of influenza virus were detected, with a positive rate of 15.22% and the percentage of A(H3), Type A H1N1, and Type B H1N1 being 37.81%, 11.66%, and 50.53%, respectively. The positive rate of influenza virus was the highest among patients in the 15-24 age group, and the most common strains were Type B and Type A H1N1; positive rate of A(H3) was the highest among patients over the age of 60. Conclusion After the Type A H1N1 influenza pandemic, influenza epidemic in Wuxi City between 2010 and 2012 had exhibited a regular seasonality; ILI and positive rate of influenza virus peaked twice each year, in winter/spring and in summer to be more specific. Prevalence of dominant strains had shown a certain degree of regularity, and influenza virus activity had been correlated with ILI. ILI surveillance data from some county areas was high in sensitivity and in consistency between ILI% and positive rate.更多还原