CAJ | 학술논문

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.
목적 료해엄주시H7N9금류감역정병개전쾌속풍험감측평고,위주호응급준비제공의거.방법 수궤추검활금시장금류화외배경,병조사활금시장당구급종업인원방호정황.대야조(후조)서식지조분진행채양화방담공작인원.정리분석불명원인폐염감측계통수거화개전중증폐염감측.채용RT-PCR방법검측표본H7N9아형급H5화H9아형금류감병독핵산.결과 공채집엄주시12개구(현)13가활금시장49개당구상관표본300빈,균미검출H7N9금류감병독.1빈침판식자검출H5아형핵산양성,양성솔위0.33％；4빈표본(계롱、압롱、침판、합롱)검출H9아형핵산양성,양성솔위1.33％.근1개월미발현병、사금(조)화출현류감양증상적종업인원.21.2％(7/33)당구소수활금미분“삼간식”(수매、도재、존란)；10.3％(4/39)적당구＞4d재청길롱구；현장재살금류시부3.7％(2/54)종업인원대구조,40.7％(22/54)대수투.102빈조분채양균미검출H7N9금류감병독핵산.질병감측계통근2개월미발현불명원인폐염병례.4월3-17일전시공상보중증폐염병례26례,H7N9금류감병독검측균음성.결론 근거금류배경표본실험실검측、인군불명원인폐염감측화중증폐염배사,이급시장상관인원방호수평등조사결과,판단엄주시우4월초잠무H7N9금류감역정,단유우활금시장대금류감방공조시화종업인원방범의식불족,잉존재출현병례적풍험.
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 carting 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 3rd to 17th,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.