廣東省首例輸入性甲型H1N1流感病例的流行病學分析和國境檢疫意義探討

Epidemiological analysis of first imported case of influenza A( H1N1) in Guangdong Province and implication of frontier quarantine

作者：劉于飛；沈紀川；楊智聰；李海麟；張力；狄飚；吳新偉

機構：廣州市疾病預防控制中心；茂名市疾病預防控制中心（廣東省現場流行病學培訓項目）

【摘要】 目的  調查分析廣東省首例輸入性甲型H1N1流感病例的流行病學特征,探討發病特點,評估防控措施,為預防和控制甲型H1N1流感提供依據。方法  采用面對面病例個案調查和現場調查方法,描述病例發病過程,分析病例的流行病學特征。結果  患者,男性, 59歲,廣州市居民, 2009年4月21日至5月12日赴美國、加拿大(均為甲型H1N1流感疫區)旅游, 5月13日經韓國抵達香港, 5月14日晚患者自覺咽痛、鼻塞、干咳, 5月15日乘坐列車從香港抵達廣州,在口岸檢疫時發現其發熱,并送往指定收治醫院。患者臨床表現較輕,發熱持續3 d,其咽拭子甲型H1N1流感病毒核酸檢測陽性。該病例被確診為廣東省首例輸入性甲型H1N1流感病例。95名密切接觸者中有85名接受醫學觀察,期間6人曾出現發熱或上呼吸道癥狀,經實驗室檢測排除甲型H1N1流感病毒感染。經采取嚴格防疫措施,該起疫情未出現二代病例。結論  該疫情確診為廣東省首例輸入性甲型H1N1流感病例,患者可能在美國、加拿大等疫區旅游期間受感染。口岸檢疫能在新發和輸入性傳染病疫情的早期發現入境者中的可疑病例。及早對可疑持續發熱病例進行實驗室檢測,早診斷、早隔離、早治療,加強密切接觸者的隔離與管理,是早期控制甲型H1N1流感疫情的有效措施。

【Abstract】　Objective　Through epidemiological survey and analysis of the first imported influenza A (H1N1) case in Guangdong Province to find out the epidemiological characteristics and to evaluate and provide reference data for the strategy of prevention and control. Methods　Interview and field investigation were conducted to describe the whole process of the case and to analyze the epidemiological characteristics of the case. Results　The case was a male aged 59 years and resident of Guangzhou. He traveled to the United States and Canada from April 21 to May 12, 2009 and reached Hong Kong on May 13 through Korea. His symptoms of sore throat, cough and nose stuffy firstly occurred on May 14. The case was firstly found by Guangzhou Entry - Exit Inspection and Quarantine Bureau when he reached Guangzhou through Hong Kong by train, with throat swab tested positive to H1N1 viral nucleic acid. His clinical symptoms were slight, but constantly fever for 3 days. The case was diagnosed as the first influenza A (H1N1) case in Guangdong Province. Six of the 95 contact persons appeared fever or upper respiratory symptoms through the medical observation, but influenza virus infection was excluded by laboratory testing. No other new second case was found after the isolation and antisepsis were taken. Conclusion　This is the first imported influenza A (H1N1) case in Guangdong Province by traveling to the United States and Canada. Entry – exit quarantine could find suspicious case of new infectious disease and imported cases firstly and effectively. Enhancing management of contact persons, promoting propaganda, early test, early diagnose, early treatment and early isolation for the suspicious case with fever were effective measures of controlling and preventing influenza A (H1N1) infection.

【關鍵詞】　甲型H1N1流感；輸入性病例；流行病學

【Key words】　Influenza A (H1N1) ; Imported case; Epidemiology

中文刊名：華南預防醫學, 2009年 05期

中圖分類號：R51117　　文獻標識碼：A　　文章編號： 1671 - 5039 (2009) 05 - 0047 - 04