Comparative epidemiology of human infections with avian influenza A H7N9 and H5N1 viruses in China: a population-based study of laboratory-confirmed cases.
Comparative epidemiology of human infections with avian influenza A H7N9 and H5N1 viruses in China: a population-based study of laboratory-confirmed cases.
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DOI：
10.1016/s0140-6736(13)61171-x
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发表时间：
2013-07-13
期刊：
影响因子：
168.9
通讯作者：
Yu, Hongjie
中科院分区：
文献类型：
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作者：
Cowling, Benjamin J.;Jin, Lianmei;Lau, Eric H. Y.;Liao, Qiaohong;Wu, Peng;Jiang, Hui;Tsang, Tim K.;Zheng, Jiandong;Fang, Vicky J.;Chang, Zhaorui;Ni, Michael Y.;Zhang, Qian;Ip, Dennis K. M.;Yu, Jianxing;Li, Yu;Wang, Liping;Tu, Wenxiao;Meng, Ling;Wu, Joseph T.;Luo, Huiming;Li, Qun;Shu, Yuelong;Li, Zhongjie;Feng, Zijian;Yang, Weizhong;Wang, Yu;Leung, Gabriel M.;Yu, Hongjie
新型甲型流感（H7N9）病毒最近出现，而甲型流感（H5 N1）病毒自2003年以来在中国大陆感染人类。这两种感染被认为主要是人畜共患病。我们比较了迄今为止中国大陆两种病毒实验室确诊病例的流行病学特征。建立了一个综合数据库，其中包含截至2013年5月24日向中国疾病预防控制中心报告的实验室确诊的A（H7N9）和A（H5 N1）病例的人口统计学、流行病学和临床变量信息。我们按年龄、性别和地理位置描述了疾病发生情况，并估计了关键的流行病学参数。在确诊的A（H7N9）和A（H5 N1）患者中，分别有130和43例，中位年龄分别为62岁和26岁。在城市地区，这两种病毒的病例中有74%是男性，而在农村地区，甲型（H7N9）和甲型（H5 N1）的比例分别为62%和33%。在A（H7N9）和A（H5 N1）病例中，75%和71%报告最近接触过家禽。A（H7N9）和A（H5 N1）的平均潜伏期分别为3.1和3.3天。平均而言，城市和农村地区每例甲型H7N9病例分别追踪到21名和18名接触者;而甲型H5 N1病例分别为90名和63名。A（H7N9）和A（H5 N1）的住院死亡风险分别为35%（95%CI：25%，44%）和70%（95%CI：56%，83%）。与农村病例相比，城市病例的性别比例与家禽暴露导致感染风险相一致。然而，鉴于大多数甲型H7 N9病例发生在老年人中，而大多数甲型H5 N1病例发生在年轻人中，因此这两种不同病毒对严重疾病的易感性差异仍然无法解释。中国科学技术部;中国香港特别行政区传染病控制研究基金和大学赠款委员会;以及美国国立卫生研究院。
The novel influenza A(H7N9) virus recently emerged, while influenza A(H5N1) virus has infected humans since 2003 in mainland China. Both infections are thought to be predominantly zoonotic. We compared the epidemiologic characteristics of the complete series of laboratory-confirmed cases of both viruses in mainland China to date. An integrated database was constructed with information on demographic, epidemiological, and clinical variables of laboratory-confirmed A(H7N9) and A(H5N1) cases that were reported to the Chinese Center for Disease Control and Prevention up to May 24, 2013. We described disease occurrence by age, sex and geography and estimated key epidemiologic parameters. Among 130 and 43 patients with confirmed A(H7N9) and A(H5N1) respectively, the median ages were 62y and 26y. In urban areas, 74% of cases of both viruses were male whereas in rural areas the proportions were 62% for A(H7N9) and 33% for A(H5N1). Among cases of A(H7N9) and A(H5N1), 75% and 71% reported recent exposure to poultry. The mean incubation periods of A(H7N9) and A(H5N1) were 3.1 and 3.3 days, respectively. On average, 21 and 18 contacts were traced for each A(H7N9) case in urban and rural areas respectively; compared to 90 and 63 for A(H5N1). The hospitalization fatality risk was 35% (95% CI: 25%, 44%) for A(H7N9) and 70% (95% CI: 56%, 83%) for A(H5N1). The sex ratios in urban compared to rural cases are consistent with poultry exposure driving the risk of infection. However the difference in susceptibility to serious illness with the two different viruses remains unexplained, given that most A(H7N9) cases were in older adults while most A(H5N1) cases were in younger individuals. Ministry of Science and Technology, China; Research Fund for the Control of Infectious Disease and University Grants Committee, Hong Kong Special Administrative Region, China; and the US National Institutes of Health.