【作者】 马鑫；

【导师】 郑玉建； 李新兰；

【作者基本信息】 新疆医科大学 ， 公共卫生， 2008， 硕士

【摘要】 目的探讨新疆流感流行规律,便于做好流行性感冒的预防与控制工作。方法通过流感监测系统,对流感进行流行病学、病原学和血清学监测。结果通过对新疆2004～2008年监测资料进行分析,发现新疆4家国家级流感监测哨点医院的呼吸道感染病例占门诊总病例数的4.33%～7.52%。ILI流行高峰主要集中在11月至次年1月。4年中发生23起流感暴发疫情,各年度暴发疫情优势株不同,且2005和2006年的流感暴发疫情漏报率过高。2004～2008年度共分离到230株流感病毒,病毒分离率以2005～2006年度最高(34.1%),2006～2007年度骤然降低(4.7%),各年度流感优势株均不相同。新疆一般人群H1N1、H3N2亚型、B型(Victoria系)和B型(Yamagata系)抗体阳性率分别为82.79%, 86.74%, 57.91%和55.81%。喀什市各型流感抗体阳性率均高于伊宁市,且高年龄组抗体阳性率要高于低年龄组。结论通过流感监测系统发现,新疆流感活动高峰时间为每年冬、春季,各年度流感流行优势株不同。根据流感毒株变化趋势发现每年引起春季流感暴发的流行株会成为当年冬季流感流行的优势株,因此预测2008～2009年度流感流行优势株为A1(H1N1)亚型。人群中A型流感抗体水平均较高并达到人群保护水平,B型流感抗体没有达到保护水平,出现暴发疫情危险依然存在。根据新疆流感监测结果、流感高发季节和疫苗保护期,建议疫苗最佳接种时间为9月～11月。样本的采集质量严重影响病毒分离率,采集合格的样本是病毒分离的基础;同样,由于2005年和2006年流感暴发疫情漏报率过高,导致暴发规模无法准确分析,所以今后的预防控制工作还需要进一步加强。自2003年以来新疆共发生动物禽流感疫情13起,并于2006年发生一起人感染禽流感病毒(H5N1亚型)死亡病例,禽流感病毒是否有可能变为全球大流行株需要密切关注,这些决定了新疆开展流感监测的意义非常重大。更多还原

【Abstract】 Objective To explore the law of influenza activity for the control and prevention of influenza. Methods Monitor influenza epidemiologically, etiologically, serologically by influenza surveillance system. Results After epidemiological surveillance from2004 to 2008, it was found that 4.33%～7.52% of the total outpatients from 2004～2008 were respiratory infection cases in 4 monitor hospitals in Xinjiang Uygur Autonomous Region by using the surveillance system. According with the popularity in wintertime and springtime of north area, The ILI reached the peak in November and January of the secondary year, There were 23 outbreaks reported during the 4 years, and the missing report rate of outbreaks in 2005～2006 was relevantly high. During the pathogenic surveillance in 2004～2008, 230 strains of influenza viruses were isolated, and the positive rate of the isolated viruses reached the peak in 2005～2006(34.1%), and decreased fiercely in 2006～2007(4.7%). The predominance strain was different in each year. Through the serological surveillance, the positive rates of antibodies against H1N1, H3N2, B (Victoria) and B (Yamagata) in general group were 82.79%, 86.74%, 57.91%, and 55.81% respectively. The positive rates of antibodies in Kashi City was higher than in Yining City, and the positive in the high age groups rate were higher than in the low age groups. Conclusion Through influenza surveillance, it can be predicted accurately that the activity of influenza reached the peak in wintertime and springtime every year. The predominance strain was different in each year, and the outbreaks of predominance strain in springtime would also be popular strain in winter in the same year. Therefore, it can be safely predicted that the popular strain would be the subtype of A1(H1N1).The level of A-type influenza antibodies was high and reached the average level of human population protection, however, the level of B-type influenza antibodies did not reached the average level, so the outbreak of influenza may be possible. According to the Xinjiang influenza surveillance, the law of influenza outbreak and the period of validity of vaccine protection, it can be suggested that the reasonable inoculated time was from September to November. Through the research, it can be found that the sample quality could influence the virus isolation rate, so qualified sample was the basis of virus isolation. Likewise, during the ILI surveillance, the scope of outbreaks in 2005 and 2006 was not estimate because of high missing report rates of influenza. The prevention and control work must be strengthened in the future. From 2003, 13 avian influenza (H5N1) outbreaks were reported in Xinjiang with 1 human avian dead case. Whether the avian flu virus would become a pandemic strain in human has become a matter of global concern. Therefore, influenza surveillance in Xinjiang Uygur Autonomous Region is very important.更多还原