摘要
目的掌握上海市长宁区2022–2023年冬春季流行性感冒(简称流感)流行情况及病原学特征,为流感防控及预警监测提供依据。方法通过中国流感监测系统,收集上海市长宁区2022年11月–2023年5月间流感样病例(ILI)相关数据,利用R4.2.2软件进行统计分析。对ILI样本采用荧光定量PCR开展核酸检测,选取MDCK细胞病毒分离法分离培养流感毒株进行全基因组测序,进行HA、NA基因进化及氨基酸变异分析(分析HA、NA基因特征)。结果2022–2023年冬春季期间长宁区医疗机构发热门诊呈现两波就诊高峰,主要由新冠病毒及流感病毒交替出现引起。送检的1040份样本中流感病毒阳性检出率为31.06%。其中,甲型流感占比99.38%(321例),乙型Victoria系占0.62%(2例)。在甲型流感病例中,H1N1型占81.93%(263例),H3N2型占18.06%(58例)。监测期间,不同年龄组中,青少年(12~18岁)组流感阳性率最高为42.86%(24/56),不同年龄组流感阳性率差异有统计学意义(P<0.001),不同性别的流感病毒检出率差异无统计学意义(χ^(2)=2.77,P=0.096)。经过基因测序发现,本轮流感流行株与本季疫苗株吻合率较高,耐药位点监测结果显示,未检出对神经氨酸酶抑制剂(NAIs)类药物的耐药情况。结论本季疫苗株与流行毒株匹配度较高,提示目前疫苗保护效果较好,近期流感大流行的风险较低,但需进一步加强多维度综合监测预警,提高流感流行趋势研判的科学性。
Objective To understand the epidemiological situation and etiological characteristics of influenza(abbreviated as flu)in Changning District of Shanghai between winter 2022 and spring 2023 so as to provide a basis for influenza prevention,control,early warning and monitoring.Methods Influenza-like illness(ILI)related data in Changning District,Shanghai from November 2022 to May 2023 were collected from China Influenza Surveillance System.R4.2.2 software was used for statistical analysis.Fluorescent quantitative PCR was used for nucleic acid detection of ILI case specimens.MDCK cytoviral isolation method was selected to isolate and culture influenza strains for whole genome sequencing,as well as analysis of the evolution of HA and NA genes and amino acid variation(to analyze the characteristics of HA and NA gene).Results During the winter and spring of 2022-2023,the fever clinic of medical institutions in Changning District experienced two waves of outpatient visit peaks,mainly caused by the alternate emergence of COVID-19 and influenza viruses.In the 1040 samples submitted for testing,the positive detection rate of influenza viruses in this round of monitoring was 31.06%,predominantly influenza A for 99.38%,of which H1N1 accounted for 81.93%,H3N2 accounted for 18.06%,and the rest were B Victoria series.During the monitoring period,the highest influenza positive rate was 42.86%(24/56)in adolescents(12-18 years old)with significant differences among different age groups(P<0.001)while there was no significant difference between different genders(χ^(2)=2.77,P=0.096).Genetic sequencing revealed a high coincidence rate between the circulating influenza strains in this epidemic and the seasonal vaccine strains.Surveillance results for drug-resistant sites indicated no occurrence of resistance to neuraminidase inhibitors(NAIs).Conclusion The high matching degree between the vaccine strains and the circulating strains in this season suggests that the current vaccine protection effect is good and the risk of influenza pandemic is low in the near future.However,it is necessary to further strengthen multidimensional comprehensive surveillance and early warning to improve the scientific analysis of influenza epidemic trends.
作者
鲁嘉妮
郭家胤
何晓定
祝慧维
顾玉婷
徐阳
LU Jiani;GUO Jiayin;HE Xiaoding;ZHU Huiwei;GU Yuting;XU Yang(Shanghai Changning District Center for Disease Control and Prevention,200051,China)
出处
《中国医药生物技术》
2025年第3期281-289,共9页
Chinese Medicinal Biotechnology
基金
上海市长宁区卫健委科研课题(20234Y026)。
关键词
流行性感冒
病原学
监测预警
influenza
etiology
monitoring and early warning
