某高校甲型H1N1流感防控措施及效果评价

本文回顾分析了南京中医药大学甲型H1N1的流感防控工作.2009年9月-2010年1月,共出现发热病人1 153例,收入医院隔离治疗498例.总结不同阶段采取的各类防控举措,通过领导重视、责任明晰,健全的应急预案和工作制度,普及防控知识,完善的疾病监测与报告系统,设置发热门诊和隔离观察区等全方位的防控措施,迅速控制了疫...     

甲型H1N1流感社区防控措施的决策与效果评价

面对甲型H1N1流感聚集性疫情爆发,政府高度重视、科学决策,采取多种有效防控措施积极应对,各部门相互配合和协调,有效控制了甲型H1N1流感的流行和传播,取得良好效果,体现了传染病防控工作政府主导、部门配合、社区共同参与的重要性。2009年6月18日我镇发生了一起学校聚集性甲型H1N1流感（以下简称甲流）事件,这是国内报道的首起学校内聚集性甲流事件,引起了社会的广泛关注。事件发生后,各级政府、相关部门高度重视,迅速启动甲型H1N1流感应急预案,采取了联防联控措施,在多部门的协作努力下,疫情很快被平息。我镇在本次疫情防控中的决策和措施得到各级政府、相关部门的肯定,防控措施效果良好,同时,也为我国甲流防控工作提供了很好的参考。     

北京市顺义区甲型H1N1流感健康教育效果评价

目的了解顺义区居民对甲型H1N1流感疫情的相关知识、态度以及行为改变情况,评价健康教育效果,为今后开展突发公共卫生事件健康教育工作总结经验。方法甲型H1N1流感流行期间及时实施干预措施,即在全区范围内开展形式多样的健康教育活动。采用分层随机抽样方法,于甲型流感开始时（2009年5月）和结束后（2010年3月）分别随机抽取顺义区社区、村及职业人群开展调查。结果干预后公众对容易感染甲型H1N1流感的行为知晓率由32.8%提高到78.3%、预防甲型H1N1流感的有效手段知晓率由16.4%提高到60.2%,公众对该次疫情信息公布工作的满意度由82.1%提高到92.4%。结论在应对突发公共卫生事件时,在全社会范围内开展大规模的健康教育是有效果而且非常有必要的;绝大多数居民对于政府应对突发公共卫生事件时信息发布工作满意,今后可以继续充分利用大众媒体向居民宣传相关知识和应对措施,及时发布最新流行态势等。     

衢州市甲型H1N1流感流行特征及防控效果评价

目的分析衢州市甲型H1N1流感（以下简称甲流）的流行特征及监测情况,为科学防控提供依据。方法收集衢州市2009年甲流疫情资料及监测资料,用Excel 2003和SPSS 13.0对所有数据进行整理和分析。率的比较采用卡方检验,P〈0.05差异有统计学意义。结果衢州市2009年共报告甲流238例,其中重症16例、危重6例,无死亡病例报告。238例甲流病例中,累计住院治疗61例,占所有报告病例的25.63%。柯城区报告病例数占所有报告病例数的73.53%,发病时间先上升后下降,以11月份报告病例数最多,发病人群主要是学生,占所有报告发病数的61.34%,无医务人员感染。监测结果显示,衢州市流感样病例（ILI）的阳性率为59.18%,甲流占所有阳性结果的61.80%。结论前期围堵为甲流防控争取了时间,今后还应加强疫情监测的强度和分析的深度,将甲流疫苗接种列入计划免疫,适时调整防控措施。     

石河子市2009年甲型H1N1流感防控现状及对策

目的及时了解与掌握甲型H1N1流感疫情动态,为制订科学有效的防控措施提供依据。方法从石河子市2009年9～12月4 960例流感样病例中抽样208名进行实验室血清学检测。结果实验室确诊病例56例,采样病例阳性率26.92%,无重症和死亡病例。结论甲型H1N1流感防控形势依然严峻,在认真执行甲型H1N1流感监测方案(第三版)的同时,疾病控制机构仍需进一步加强突发公共卫生事件应急能力建设,增加物资储备及宣传教育力度。     

2009年北京市昌平区甲型H1N1流感流行特征

目的分析2009年昌平区甲型H1N1流感的流行病学特征,探索其流行规律,为制定相关预防控制措施提供科学依据。方法采用描述性流行病学方法,对2009年昌平区H1N1流感病例的疫情资料进行分析,个案调查表录入Epidata3.02数据库,运用Excel 2007和SPSS 17.0软件进行统计分析。结果 417例病例主要分布在人口密集地区。男女性别比1.74∶1;以10～19岁年龄组病例数最多,占总病例数的47.96%;发病人群以青少年学生病例数最多,占67.71%。发病高峰出现在9月,占全年总发病的43.65%。结论学生是甲型H1N1流感的高发人群,应采取重点人群接种甲型H1N1流感疫苗为主的综合性防控措施,有效控制甲型H1N1流感疫情蔓延。     

甲型H1N1流感医学观察13例防控措施

目的探索对甲型H1N1流感患者的密切接触者进行医学留观集中管理的防控措施。方法本次防控工作结束后,回顾性总结对13例甲型H1N1流感患者的密切接触者进行医学留观处置过程、医务人员自身防护及存在缺陷。结果通过这次应急实施甲型H1N1流感医学留观人员防控措施,使防控工作符合程序,防护操作规范、标准。结论正确规范地实施消毒隔离措施和加强个人防护,是预防甲型H1N1流感发生医院感染的重要措施和医疗安全的基本保证。     

甲型H1N1流感社会防控督查效果分析

目的探讨督查机制在防控甲型H1N1流感中的作用,探索应对突发公共卫生事件督查工作的有效方式。方法对北京市2009年6月至12月防控甲型H1N1流感的督查机制、方式和效果进行分析。结果督查对督促落实防控甲型H1N1流感的四方责任起到了积极作用。结论督查是政府防控突发公共卫生事件的保障机制之一,督查作用的有效发挥离不开围绕中心工作精心谋划以及机制完善。     

某铁路局防控甲型H1N1流感体会

甲型H1N1流感在全世界范围内暴发流行,给人们的生产、生活构成极大危胁,其发病率、死亡率高,而且疫情有进一蔓延的态势。为加强甲流防控工作,更好的为铁路安全运输保驾护航,本研究通过对某铁路局甲流防控工作的分析、体会,既对防控工作取得的成绩和经验进行了总结,又对工作中的不足提出了改进建议。     

口岸甲型H1N1流感防控措施的卫生经济学评价

目的从卫生经济学的角度评价2009年武汉航空口岸甲型H1N1流感防控措施,为口岸呼吸道传染病防控措施的制定提供依据。方法设计调查表,收集2009年甲流防控期间,武汉天河国际机场旅客留验、转运、诊治等的成本资料,将口岸防控模式与两种理论防控模式,即改良的口岸防控模式和社区防控模式进行比较,用卫生经济学成本最小化分析、成本-效果、成本-效益分析方法进行评价。结果三种防控模相比,改良的口岸防控模式成本最小;口岸防控与社区防控相比,预防1例甲流病例将节省成本7505.35元,成本效益比是4.58。结论改良的口岸防控模式是卫生经济学最优模式。     

Outbreaks of pandemic (H1N1) 2009 and seasonal influenza A (H3N2) on cruise ship

To determine the extent and pattern of influenza transmission and effectiveness of containment measures, we investigated dual outbreaks of pandemic (H1N1) 2009 and influenza A (H3N2) that had occurred on a cruise ship in May 2009. Of 1,970 passengers and 734 crew members, 82 (3.0%) were infected with pandemic (H1N1) 2009 virus, 98 (3.6%) with influenza A (H3N2) virus, and 2 (0.1%) with both. Among 45 children who visited the ship's childcare center, infection rate for pandemic (H1N1) 2009 was higher than that for influenza A (H3N2) viruses. Disembarked passengers reported a high level of compliance with isolation and quarantine recommendations. We found 4 subsequent cases epidemiologically linked to passengers but no evidence of sustained transmission to the community or passengers on the next cruise. Among this population of generally healthy passengers, children seemed more susceptible to pandemic (H1N1) 2009 than to influenza (H3N2) viruses. Intensive disease control measures successfully contained these outbreaks.     

北京市2009年甲型H1N1流感疫情分析

目的 分析北京市2009年甲型H1N1流感流行病学特征.方法 采用SPSS11.0软件,对北京市2009年甲型H1N1流感确诊病例的流行病学特征进行描述与分析.结果 2009年北京市共确诊甲型H1N1流感10 802例,重症、危重症病例621例,死亡73例,病死率为0.7%(73/10 802);北京市甲型H1N1流感流行过程可分为输入期、传播期、扩散期、稳中有降期等4个阶段;感染者以青少年为主,占47.9%(5169/10 802),男女性别比为1.3:1;职业分布以学生最多,占52.2%(5 639/10 802),重症、危重症病例及死亡病例均以离退人员为多,分别为15.9%(99/621)及23.3%(17/73);10月份达到流行高峰.结论 北京市2009年甲型H1N1流感病例以青少年学生为主,重症、危重症病例及死亡病例均以离退人员为多.     

社区甲型流感临床特征分析与比较

目的分析和比较社区散发新型甲型H1N1流感和季节性流感临床特征,为临床诊治甲型流感提供参考依据。方法回顾性分析2009年5-10月来医院发热门诊就诊的具有流感样症状的患者,均经实时荧光定量PCR检测。结果在确诊的129例甲型流感患者中,新型甲型H1N1流感65例,占50.4%,季节性甲型流感64例,占49.6%;新型甲型H1N1流感组平均年龄21岁,季节性甲型流感组36岁,两组差异有统计学意义(P<0.01);新型甲型H1N1流感组学生占47例,占72.3%,季节性甲型流感组13例,占20.3%,两组差异有统计学意义(P<0.01);从临床表现比较,除流涕、扁桃体肿大,两组差异有统计学意义(均P<0.01)外;其他差异均无统计学意义。结论医院确诊的甲型流感患者均为轻型;新型甲型H1N1流感以年轻学生为主;两组甲型流感临床特征相似,需经PCR检测确诊分型。     

2009年北京市学生甲型H1N1流感流行特征

目的描述北京市学生甲型H1N1流感感染情况,分析其流行各阶段的特征。方法收集2009年5月11日～12月31日中国疾病预防控制中心(CDC)《疾病监测信息系统》中报告的学生甲型H1N1流感确诊病例个案信息,应用Excel和SPSS统计软件进行分析。结果 2009年5月11日～12月31日,北京市共确诊甲型H1N1流感学生病例6568例,平均年龄(13.7±4.0)岁,小学和初中学生最多,占68.87%。甲型H1N1在学生中的传播过程分为4个时期。5～6月以外籍输入性病例为主,7～8月聚集性疫情由中小学生向大学生扩散,9～10月,日均确诊病例数突增至94.58人/d,城区发病人数是郊区的2.04倍,44.40%的确诊病例为学校聚集性病例,11～12月,日均确诊病例数迅速下降至3.06人/d,进入12月以后维持在较低水平。结论北京市学生甲型H1N1流感流行特征为:低年龄组高发,从低年龄组向高年龄组扩散,城区向郊区扩散和学校聚集性的特点。     

北京市人群甲型H1N1流感血清流行病学调查

目的 了解和掌握北京市人群对甲型H1N1流感的免疫水平.方法 在2009年11月27日至12月23日从医院患者(排除感染科和呼吸科)、血液中心志愿者和体检中心健康体检者中随机选取调查对象进行问卷调查,并采集血清标本进行甲型H1N1流感病毒血凝抑制(HI)抗体检测.结果 共选取调查对象856名,其中127名(14.8%)调查对象体内甲型H1N1流感病毒HI抗体为阳性.0～5岁、6～17岁、18～55岁、≥56岁年龄组HI抗体阳性率分别为14.5%、19.4%、17.4℅和8.0%(P=0.009).不同性别HI抗体阳性率差异无统计学意义(P=0.693).人群血清HI抗体年龄加权阳性率为15.8%.多因素logistic回归分析显示,年龄、出现过急性呼吸道症状以及接种甲型H1N1流感疫苗与HI抗体阳性呈显著性相关.结论 北京市已经有超过15%的人群具有甲型H1N1流感保护性抗体,普通人群中已经建立一定的免疫屏障.     

The 2009 A (H1N1) influenza virus pandemic: A review

In March and early April 2009 a new swine-origin influenza virus (S-OIV), A (H1N1), emerged in Mexico and the USA. The virus quickly spread worldwide through human-to-human transmission. In view of the number of countries and communities which were reporting human cases, the World Health Organization raised the influenza pandemic alert to the highest level (level 6) on June 11, 2009. The propensity of the virus to primarily affect children, young adults and pregnant women, especially those with an underlying lung or cardiac disease condition, and the substantial increase in rate of hospitalizations, prompted the efforts of the pharmaceutical industry, including new manufacturers from China, Thailand, India and South America, to develop pandemic H1N1 influenza vaccines. All currently registered vaccines were tested for safety and immunogenicity in clinical trials on human volunteers. All were found to be safe and to elicit potentially protective antibody responses after the administration of a single dose of vaccine, including split inactivated vaccines with or without adjuvant, whole-virion vaccines and live-attenuated vaccines. The need for an increased surveillance of influenza virus circulation in swine is outlined.     

2009年上海市甲型H1N1流感疫苗大规模人群接种免疫学效果评价

目的评价2009-2010年上海市甲型H1N1流行性感冒疫苗(甲流疫苗)的免疫学效果。方法以公安人员、中小学生、医务人员这三类重点人群作为免疫学评价的对象,采用分层抽样的方法在上海市4个区县抽取公安人员110人,中小学生146人,医务人员306人,于甲流疫苗接种前和接种后5~6周分别采集外周静脉血,检测甲型H1N1流感(甲流)抗体水平,进行甲流疫苗免疫学效果评价。结果总体上,甲流抗体阳性率由接种前34.9%提高到98.9%,抗体几何平均滴度(GMT)由接种前1∶17提高到1∶351,抗体≥4倍增长率为85.6%。结论 2009年上海市大规模人群接种的甲流疫苗具有良好的免疫学效果。     

Central European Vaccination Advisory Group (CEVAG) guidance statement on recommendations for 2009 pandemic influenza A(H1N1) vaccination

The 2009 influenza A(H1N1) pandemic is markedly different from seasonal influenza with the disease affecting the younger population and a larger than expected number of severe or fatal cases has been seen in pregnant women, obese people and in people who were otherwise healthy. In Europe, influenza activity caused by the 2009 influenza A(H1N1) virus has passed the winter peak with nearly all countries now reporting lower influenza activity. However, although the rate of 2009 pandemic influenza A(H1N1) is declining, fatal cases continue to be reported and the future is hard to predict. The most effective protection against influenza is vaccination and increasing vaccine coverage is the only way to eliminate uncertainties regarding possible future waves of 2009 pandemic influenza A(H1N1). Recommendations have been developed for several central European countries but there is no clear or uniform definition with respect to priority groups or age groups who should receive vaccination. This paper contains the Central European Vaccination Advisory Group (CEVAG) guidance statement on recommendations for the vaccination of adults and children against 2009 pandemic influenza A(H1N1). CEVAG recommends vaccination of all health-care workers, pregnant women, children ≥6 months and <2 years of age and people with chronic medical conditions as a first priority.     

Immune response of single dose vaccination against 2009 pandemic influenza A (H1N1) in the Taiwanese elderly

We conducted a multi-center, randomized and laboratory-blinded clinical trial with subgroup analyses, involving adults aged greater than 60 years old (range 61–86 years old), to investigate the immunogenicity and the potential factors affecting the immune response of a monovalent, unadjuvanted, inactivated, split-virus vaccine. A total of 107 subjects were randomized to receive 15 and 30 μg of hemagglutinin antigen in a 1:1 ratio. The immunogenicity was detected through hemagglutination inhibition (HAI) test of serum obtained before and 3 weeks after vaccination. By 3 weeks after vaccination, HAI titer ≧1:40 was observed in 75.5% and 81.1% of participants receiving 15 and 30 μg of hemagglutinin antigen, respectively. Positive seroconversion was observed in 71.7% and 81.1% of recipients of the 15 and the 30 μg, respectively. The GMTs increased by a factor of 10.7 and 17.4 in the groups of 15 and 30 μg, respectively. This study indicated that one dose of 15 μg hemagglutinin antigen without adjuvant induced protective immune response in the majority of elderly. Multivariate logistic regression analyses showed that gender, age and diabetes were statistically significant factors affecting the seroprotection rate (p = 0.04, 0.01 and 0.01, respectively) and seroconversion rate (p = 0.01, 0.01 and 0.01, respectively).     

Serologic survey of pandemic influenza A (H1N1 2009) in Beijing, China

Objective

To examine the frequency and distribution of antibodies against pandemic influenza A (H1N1 2009) [H1N1] in populations in Beijing and elucidate influencing factors.

Methods

In January 2010, a randomized serologic survey of pandemic influenza A (H1N1 2009) was carried out. Six districts that were randomly selected with a total of 4601 participants involved in the survey have their antibody level tested by hemagglutination inhibition assay.

Results

Among the 4601 participants, the overall seropositive rate for pandemic influenza A (H1N1 2009) antibodies was 31.7%. The seropositivity prevalence in participants who received the pandemic H1N1 vaccination was 60.9%. Only 53.1% of the pandemic influenza A (H1N1 2009) seropositive individuals who had not received the vaccination experienced respiratory tract infection symptoms. Multivariate logistic regression revealed that factors such as age, occupation, dwelling type, whether the participant's family included students in school, and the vaccination history with pandemic influenza A (H1N1 2009) were associated with antibody titers (p < 0.05).

Conclusions

Our data indicated that almost 30.0% of the residents had appropriate antibody titers against pandemic influenza A (H1N1 2009) in Beijing, and these titers may provide an immune barrier.