【作者】 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；

【Author】 YUAN Jun;DI Biao;MA Xiao-wei;LIU Jian-ping;CHEN Yi-yun;LI Kui-biao;LIU Yu-fei;XIAO Xin-cai;CAI Wen-feng;LIU Yan-hui;YANG Zhi-cong;WANG Ming;Guangzhou Center for Disease Control and Prevention;School of Public Health,Sun Yat-Sen University;

【机构】 广州市疾病预防控制中心； 中山大学公共卫生学院；

【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>4d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。更多还原

【Abstract】 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 from 49 stalls in 13 food markets and a natural habitat but none showed H7N9 positive result.A chopping block was detected positive of carring 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 ILI cases among the workers were discovered.21.2%（7/33） of the stalls did not follow the set regulations for prevention.10.3%（4/39） of the stalls had the cages cleaned,4 days after the inspection.3.7%（2/54） of the workers wore masks and 40.7%（22/54） of them wore gloves during the slaughtering process.102 bird feces specimens were tested negative on H7N9 virus.No pneumonia cases with unknown reason were identified.From April 3^rd to 17^th we found 26 severe pneumonia cases but with negative results on influenza A（H7N9）.Conclusion According to the data and information from 1)lab tests,2) pneumonia cases with unknown 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 epidemic 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.更多还原