部队呼吸道腺病毒疫情流行病学调查分析

汤芳; 张在忠; 王晓芹; 朱光; 浮飞翔; 曹德康

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武警医学 ›› 2020, Vol. 31 ›› Issue (5) : 373-377.

论著

部队呼吸道腺病毒疫情流行病学调查分析

汤芳¹, 张在忠², 王晓芹¹, 朱光¹, 浮飞翔¹, 曹德康¹

作者信息 +

Epidemiological investigations of outbreaks of human adenovirus associated respiratory diseases in military units

TANG Fang¹, ZHANG Zaizhong², WANG Xiaoqin¹, ZHU Guang¹, FU Feixiang¹, CAO Dekang¹

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摘要

目的分析我国部队呼吸道腺病毒暴发疫情的流行特点、暴发原因及临床表现,为有效控制疾病的发生与蔓延提供依据。方法从PubMed、万方数据库搜集2009-2017年国内公开报道的部队呼吸道腺病毒暴发疫情文献,对疫情暴发的流行病学特征和临床表现进行统计分析。结果病原分型:7型、55型暴发病例最多,分别占暴发疫情的47.11%(1782/3783)和30.11%(1139/3783)。7型10起,检测数551例,阳性率为54.02%(551/1020);55型5起,检测数1035例,阳性率为90.10%(437/485);时间分布以2013年最多,共发生7起;发病时间主要集中在每年12月至次年3月;河南地区报告最多,共发生4起;主要以新兵为高发人群,共18起是新兵为主的聚集性暴发疫情。呼吸道腺病毒临床表现主要为发热(50.83%~100.00%)、咽部充血(37.91%~100.00%)、咳嗽(48.17%~95.45%)、咽痛(57.14%~87.00%)、咳痰(15.66~85.23%)等症状。结论呼吸道腺病毒是引起部队暴发疫情的主要病原体之一,提示应加强疫情监测和防控工作,防止疫情的扩大蔓延。

Abstract

Objective To analyze the epidemiology of outbreaks and clinical characteristics of respiratory diseases caused by human adenovirus (HAdV) in military units so as to provide data for disease prevention and control. Methods Data on respiratory adenovirus outbreaks between 2009 and 2017 was collected from PubMed and Wanfang Database. The epidemiologic and clinical data and the serotypes of adenovirus were also analyzed. Results The dominating serotypes of adenovirus were 7 and 55, which accounted for 47.11%(1782/3783) and 30.11% (1139/3783) of the total cases of outbreaks, respectively. There were 10 outbreaks related to serotype 7, and 54.02% of the 1020 cases were positive. There were 5 outbreaks related to serotype 55, and 90.10% of the cases (437/485) were positive. The peak time was in 2013, with four outbreaks. Seasonal outbreaks mostly occurred in spring and winter, or to be more specific, between December and March. In terms of regional distribution, Henan Province had the largest number of outbreaks. The high-risk populations were new recruits, among whom the number of outbreaks was 18. The clinical features of adenovirus infection were fever (50.83%-100.00%), pharyngeal hyperemia(37.91%-100.00%), cough(48.17%-95.45%), sore throat (57.14%-87.00%) and expectoration(15.66%-85.23%). Conclusions HAdV has become one of the main pathogenic microorganisms, which induces acute respiratory diseases in the military in China. It is necessary to reinforce epidemic surveillance to curb the spread of the disease.

导出引用

汤芳, 张在忠, 王晓芹, 朱光, 浮飞翔, 曹德康. 部队呼吸道腺病毒疫情流行病学调查分析[J]. 武警医学. 2020, 31(5): 373-377

TANG Fang, ZHANG Zaizhong, WANG Xiaoqin, ZHU Guang, FU Feixiang, CAO Dekang. Epidemiological investigations of outbreaks of human adenovirus associated respiratory diseases in military units[J]. Medical Journal of the Chinese People Armed Police Forces. 2020, 31(5): 373-377

中图分类号： R842.2

参考文献

[1] Hilleman M R. Recovery of new agent from patients with acute respiratory illness [J]. Proc Soc Exp Biol Med, 1954, 85(1):183-188.
[2] Scott M K, Chommanard C, Lu X, et al. Human adenovirus associated with severe respiratory infection, Oregon, USA, 2013-2014[J]. Emerg Infect Dis, 2016, 22(6):1044-1051.
[3] Kajon A E, Lamson D M, Bair C R, et al. Adenovirus type 4 respiratory infections among civilian adults, Northeastern United States, 2011-2015[J]. Emerg Infect Dis, 2018, 24(2):201-209.
[4] Song J, Lee H, Cho E. Epidemiological investigation of the outbreak of acute respiratory infection caused by adenovirus type B55 in a physical education school in 2017[J]. Infect Chemother, 2019, 51(2):119-129.
[5] 李争,王素玉,袁跃彬, 等. 一起呼吸道腺病毒感染暴发流行的调查[J]. 实用医药杂志,2018,28(7): 636-638.
[6] 徐军,郭静霞,李浩,等.不明原因呼吸道感染疫情病原学分析[J].解放军医学杂志,2010,35(3):252-255.
[7] 李子建,刘元东,靳晓红,等.1起由腺病毒引起的发热性呼吸道传染病疫情的调查[J].预防医学论坛, 2010,16(12):1159-1160.
[8] 田季雨,胡安恒, 潘景光,等.驻陕某部呼吸道腺病毒7型暴发166例疫情分析[J]. 解放军预防医学杂志, 2014,32(3):203-205
[9] 李森林,邓兵,杨会锁,等.55型腺病毒疫情暴发原因分析及防控对策[J].解放军预防医学杂志,2015,33(2):214.
[10] 魏爱民,郭虎芝,林静,等.某部防控重大群体疫情的做法及其启示[J],解放军预防医学,2013,31(4):352-353.
[11] 龚传明,章涛,屈磊,等.腺病毒7型急性呼吸道感染暴发流行的流行病学调查[J].西南国防医药,2014,24(5):497-499.
[12] 江宗群,段军,陈世厚,等.腺病毒7型感染306例流行病学和临床特点分析[J].临床军医杂志,2014,42(6):565-567.
[13] 黎燕,李江波,朱丹,等.一起腺病毒3型引起暴发疫情的调查[J].浙江预防医学,2014,26(5):503-504.
[14] 赵寒,李勤,龙江,等.一起腺病毒引起的急性呼吸道感染暴发调查分析[J].重庆医学,2015,44(4):506-508.
[15] 刘仰青,吴景文,李辉,等.一起由腺病毒7 型引起的呼吸道传染病聚集性疫情的流行病学调查[J].现代预防医学,2014,41(19):3481-3483.
[16] 李侠,陈方,李艾红,等.空军某部突发腺病毒Ⅶ型感染疫情调查[J].解放军预防医学杂志,2014,32(3):271.
[17] 陈应坚,李静媚,周健明,等.1起由腺病毒4型引起的呼吸道感染暴发疫情的流行病学分析[J]. 华南预防医学,2014,40(5):472-474.
[18] 陈友谊,刘明,翁余,等. 163例腺病毒军营暴发感染病原学分析[J]. 华南预防医学,2014,40(1):147-148.
[19] 王琳,陆海宇,刘其会,等.人类腺病毒B组7型致军营聚集性感染的临床特征[J].中华传染病学杂志,2015,33(2):79-82.
[20] 程霞波, 贾邯梦,吴迪,等. 某新训部队防控一起7型腺病毒感染的做法和体会[J].解放军预防医学杂志,2017,35(1):87-88.
[21] 高东旗, 李宏, 张海洋. 某部4起腺病毒疫情回顾与建议[J]. 解放军预防医学杂志, 2017,35(12):1629-1630.
[22] 佟立波,纪兆云,马凤龙,等.一起腺病毒感染暴发疫情的流行病学调查分析[J]. 实用预防医学杂志, 2016,33(8):730-731.
[23] 古良琪,刘晓莉,赵伟, 等.拉萨部队55型腺病毒呼吸道感染暴发疫情调查分析[J]. 西南国防医药, 2016,26(11):1350-1352.
[24] 马骏,杨春龙,郭金鹏,等.某部腺病毒感染疫情调查分析[J].灾害医学与救援(电子版),2018,7(1):34-36.
[25] 崔玉玲,靳晓红,裴晶,等.一起腺病毒感染暴发疫情的实验室诊断[J].实用医药杂志,2015,32(2):35.
[26] 张乃春,李文刚, 陈勇, 等. 成人腺病毒B组7型感染的临床特征分析[J]. 中华流行病学杂志, 2014,32(4):225-228.
[27] 王全楚,段新科,李争.一起肺炎支原体和腺病毒混合感染暴发疫情的调查[J].中华流行病学杂志,2009,230(7):725
[28] 张启山.某部一起腺病毒疫情的处置与启示[J].解放军预防医学杂志,2016,34(3):444-445.
[29] Cheng J, Qi X, Chen D, et al. Epidemiology and transmission characteristics of human adenovirus type 7 caused acute respiratory disease outbreak in military trainees in East China [J]. Am J Transl Res,2016 15, 8(5):2331-2342.
[30] Li J, Lu X, Sun Y, Lin C, et al. A swimming pool-associated outbreak of pharyngoconjunctival fever caused by human adenovirus type 4 in Beijing, China[J]. Int J Infect Dis, 2018, 75:89-91.
[31] Yi L, Zou L, Lu J, et al. A cluster of adenovirus type B55 infection in a neurosurgical inpatient department of a general hospital in Guangdong, China[J]. Influenza Other Respi Viruses, 2017, 11:328-336.
[32] Li X, Kong M, Su X, et al. An outbreak of acute respiratory disease in China caused by human adenovirus type B55 in a physical training facility [J]. Int J Infect Dis, 2014, 28:117-122.
[33] 毛乃颖,朱贞,雷振强,等.新型人腺病毒55型在中国10年的持续流行及其基因进化分析[J].中华实验和临床病毒学杂志,2018,32(2):124-129.
[34] Kajon A E, Hang J, Hawksworth A, et al. Molecular epidemiology of adenovirus type 21 respiratory strains isolated from US military trainees(1996-2014) [J]. J Infect Dis, 2015, 212(6):871-880.
[35] Sanchez J L, Cooper M J, Myers C A, et al. Respiratory infections in the US military: recent experience and control [J]. Clin Microbiol Rev,2015, 28(3):743-800.
[36] Rogers A E, Lu X, Killerby M, Campbell E, et al. Outbreak of acute respiratory illness associated with adenovirus type 4 at the u.s. naval academy 2016 [J]. MSMR, 2019, 26(2):21-27.
[37] Chmielewicz B, Benzler J, Pauli G, et al. Respiratory disease caused by a species β₂ adenovirus in a military camp in Turkey [J]. J Med Virol,2005,77(2):232-237.
[38] Kajon A E, Dickson L M, Metzgar D, Outbreak of febrile respiratory illness associated with adenovirus 11a infection in a singapore military training cAMP [J]. J Clin Microbiol,2010, 48(4):1438-1441.
[39] Ko J H, Woo H T, Oh H S, et al. Ongoing outbreak of human adenovirus-associated acute respiratory illness in the republic of korea military 2013-2018[J].Korean J Intern Med,2019, 5:92.
[40] 张伟龙,李增德,浮飞翔,等.人感染禽流感病毒的研究进展[J].武警医学,2014,25(2):206-209.