CAJ | 학술논문

目的探讨南宁市一起人感染H7N9禽流感的传播模式.方法应用现场流行病学方法调查2例病例及其82名密切接触者,对采集的相关标本进行H7N9禽流感病毒核酸检测和病毒分离,并分析基因序列和进化树同源性.结果病例A在最后一次暴露于广东中山市活禽市场后4d于当地发病,并在发病后第2天返回广西南宁市横县家中.病例B(病例A之子,5岁)无明确禽类接触史,但与病例A同居一室密切接触,4d后发病.从2例中均分离出H7N9禽流感病毒,2株病毒基因序列和系统进化树分析具有高度同源性,且关系最近.指示病例(病例A)的其他81名密切接触者未出现人感染H7N9禽流感病毒症状.结论二代病例(病例B)可能在无防护情况下密切接触指示病例而感染,提示H7N9禽流感病毒可通过人-人传播,但其传染力有限且非持续性.
목적 탐토남저시일기인감염H7N9금류감적전파모식.방법 응용현장류행병학방법조사2례병례급기82명밀절접촉자,대채집적상관표본진행H7N9금류감병독핵산검측화병독분리,병분석기인서렬화진화수동원성.결과 병례A재최후일차폭로우엄동중산시활금시장후4d우당지발병,병재발병후제2천반회엄서남저시횡현가중.병례B(병례A지자,5세)무명학금류접촉사,단여병례A동거일실밀절접촉,4d후발병.종2례중균분리출H7N9금류감병독,2주병독기인서렬화계통진화수분석구유고도동원성,차관계최근.지시병례(병례A)적기타81명밀절접촉자미출현인감염H7N9금류감병독증상.결론 이대병례(병례B)가능재무방호정황하밀절접촉지시병례이감염,제시H7N9금류감병독가통과인-인전파,단기전염력유한차비지속성.
Objective To understand the transmission mode of human infection with avian influenza A (H7N9) virus.Methods Field epidemiological investigation was conducted for a family clustering of human infection with H7N9 virus in Hengxian county,Guangxi Zhuang Autonomous Region in February 2014.Two patients and their 82 close contacts were surveyed.The samples collected from the patients,environments and poultry were tested by using real time reverse transcriptase-polymerase chain reaction (rRT-PCR),and the samples from patients were used for virus isolation.The samples from 5 close contacts were tested with RT-PCR.The clinical data,exposure histories of the patients and the detection results of the isolates and their homology were analyzed.Results Patient A became ill 4 days after her last exposure to poultry in Zhongshan,Guangdong province,and returned to her hometown in Hengxian 2 days after onset.Patient B was patient A' s 5 years old son,who had no known exposure to poultry but slept with patient A for 4 days.He developed symptoms 4 days after last contact with his mother.Two strains of H7N9 virus were isolated from the two patients.The 2 isolates were highly homogenous (almost 100％) indicated by gene sequencing and phylogenetic tree.None of the other 81 close contacts developed symptoms of H7N9 virus infection.Conclusion Patients B was infected through close contact with patient A,indicating that avian H7N9 virus can spread from person to person,but the transmissibility is limited and non-sustainable.