Article(id=1324050943012111337, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202601244, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1768320000000, receivedDateStr=2026-01-14, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793607944491, onlineDateStr=2026-11-02, pubDate=1778342400000, pubDateStr=2026-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793607944491, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793607944491, creator=13701087609, updateTime=1793607944491, updator=13701087609, issue=Issue{id=1324050669933572771, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='9', pageStart='1537', pageEnd='1728', issueExtLink='null', onlineDate='null', pubDate='1778342400000', pubDateStr='2026-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793607879384, creator='13701087609', updateTime=1793670100562, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324311644528050975, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324311644528050976, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1710, endPage=1716, ext={EN=ArticleExt(id=1324050943263769578, articleId=1324050943012111337, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Epidemiological and etiological surveillance of influenza-like illness in Jinhua City, Zhejiang Province during the 2017—2024 surveillance years, columnId=1228016571713520579, journalTitle=Modern Preventive Medicine, columnName=Health Supervison, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the epidemiological and etiological characteristics of influenza-like illness (ILI) in Jinhua City, Zhejiang Province, during the 2017—2024 surveillance years, and to provide a scientific basis for influenza prevention and control in the city.

Methods

ILI surveillance data from sentinel hospitals in Jinhua City during 2017—2024 surveillance years (from week 14 of the current year to week 13 of the following year) were collected through the Chinese Influenza Surveillance Information System and analyzed using descriptive epidemiological methods.

Results

During the 2017—2024 surveillance years, a total of 7 748 309 outpatient and emergency visits were reported, including 426 013 ILI cases, with an overall ILI proportion (ILI%) of 5.50%. The highest ILI% was observed in the 2022 surveillance year (8.75%), while the lowest was recorded in the 2024 surveillance year (2.66%). Marked inter-annual fluctuations in ILI activity were noted: single winter peaks occurred in the 2017—2019 surveillance years. The 2021 surveillance year exhibited multiple cross-seasonal peaks. The 2022 surveillance year showed two peaks, one in summer and the other in late winter and early spring. A single winter peak reappeared in the 2023 surveillance year, and no significant epidemic peaks were detected in the 2020 or 2024 surveillance years. ILI cases were predominantly concentrated in the 0-4 years age group, accounting for 53.45% of all reported cases. A total of 18 911 ILI specimens were tested for influenza virus, of which 3 025 were positive, yielding an overall positive rate of 16.00%. Influenza A and B viruses accounted for 71.17% and 28.56% of positive detections, respectively. Among the identified subtypes and lineages, A (H3N2) accounted for 40.89%, followed by A (H1N1) pdm09 (30.28%), B/Victoria lineage (27.17%), and B/Yamagata lineage (1.39%). No B/Yamagata virus was detected after the 2020 surveillance year. Mixed infections accounted for 0.26%. The ILI% was significantly positively correlated with the influenza virus positivity rate in the 2017, 2018, 2019, 2022, and 2023 surveillance years (P<0.001).

Conclusion

Influenza activity in Jinhua City during the 2017—2024 surveillance years exhibited distinct seasonal fluctuations and pronounced inter-annual variability. Influenza activity was markedly suppressed during the implementation of non-pharmaceutical interventions (NPIs) against COVID-19 and rebounded following their relaxation. The predominant strains alternated across surveillance years, with A (H3N2) accounting for the highest proportion, while B/Yamagata lineage was no longer detected after 2020. Further optimization of the influenza sentinel surveillance system, including strengthening multi-pathogen co-surveillance and integrated data analysis, is needed to provide scientific evidence for precision influenza prevention and control.

, authors=Zhi-feng PANG, Li-yan QIAN, Zhi-ping LONG, Peng-hong ZHANG, Guang-ming ZHANG, authorsList=Zhi-feng PANG, Li-yan QIAN, Zhi-ping LONG, Peng-hong ZHANG, Guang-ming ZHANG, authorCompany=null, correspAuthors=Guang-ming ZHANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324050945247675374, articleId=1324050943012111337, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=2017—2024监测年度浙江省金华市流感样病例流行病学及病原学监测结果分析, columnId=1228016571923235795, journalTitle=现代预防医学, columnName=卫生监督, runingTitle=null, highlight=null, articleAbstract=
目的

分析2017—2024监测年度浙江省金华市流感样病例(influenza-like illness,ILI)流行病学及病原学特征,为流感防控提供科学依据。

方法

通过中国流感监测信息系统,收集金华市2017—2024监测年度(当年第14周—次年第13周)ILI哨点监测数据,采用描述流行病学方法进行分析。

结果

2017—2024监测年度共报告门急诊病例7 748 309例,其中ILI 426 013例,总体ILI就诊百分比(ILI%)为5.50%,2022年度最高,为8.75%,2024年度最低,为2.66%。年度间ILI%波动较大:2017—2019年度为单一冬季高峰,2021年度呈“跨季节多高峰”特征,2022年度为夏季与冬末春初双高峰,2023年度回归为单一冬季高峰,2020与2024年度无显著高峰。ILI集中在0~4岁组,占53.45%。病原学检测18 911份,阳性3 025份,总阳性率为16.00%;甲型、乙型流感病毒分别占71.17%和28.56%。不同亚型构成为:A(H3N2)占40.89%,A(H1N1)pdm09占30.28%,B/Victoria系占27.17%,B/Yamagata系占1.39%且自2020监测年度之后未有检出,混合型占0.26%。ILI%与流感病毒病原阳性率在2017、2018、2019、2022及2023监测年度均呈显著正相关(P<0.001)。

结论

2017—2024监测年度金华市流感活动呈现一定的季节波动和年度差异,新型冠状病毒感染非药物干预措施实施期间流感活动受抑,措施解除后出现反弹。各监测年度优势毒株交替流行,以A(H3N2)占比最高,B/Yamagata系自2020年后未再检出。需进一步优化流感哨点监测体系,强化多病原联合监测和数据整合分析,为流感精准防控提供科学依据。

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庞志峰(1980—),男,本科,主任医师,研究方向:急性传染病预防控制工作

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章光明,E-mail:
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Nature Reviews Microbiology, 2021, 19(12): 741-742., articleTitle=Influenza lineage extinction during the COVID-19 pandemic?, refAbstract=null), Reference(id=1324050956735873088, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050943012111337, doi=null, pmid=null, pmcid=null, year=2022, volume=13, issue=1, pageStart=1721, pageEnd=null, url=null, language=null, rfNumber=[24], rfOrder=33, authorNames=Dhanasekaran V, Sullivan S, Edwards KM, journalName=Nature Communications, refType=null, unstructuredReference=Dhanasekaran V, Sullivan S, Edwards KM, et al. Human seasonal influenza under COVID-19 and the potential Consequences of influenza lineage elimination [J]. Nature Communications, 2022, 13(1): 1721., articleTitle=Human seasonal influenza under COVID-19 and the potential Consequences of influenza lineage elimination, refAbstract=null)], funds=[Fund(id=1324050950733824030, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050943012111337, awardId=2025-4-167, language=CN, fundingSource=金华市科技计划项目(2025-4-167), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324050945650328559, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050943012111337, xref=null, ext=[AuthorCompanyExt(id=1324050945671300080, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050943012111337, companyId=1324050945650328559, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Jinhua Municipal Center for Disease Control and Prevention, Jinhua, Zhejiang 321002, China), AuthorCompanyExt(id=1324050945679688689, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050943012111337, companyId=1324050945650328559, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=金华市疾病预防控制中心,浙江 金华 321002)])], figs=[ArticleFig(id=1324050947860725778, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050943012111337, language=EN, label=Figure 1, caption=Temporal distribution of influenza pathogen-positive specimens during the 2017—2024 surveillance years, figureFileSmall=2VaePY/z09lqNo9JcfIzhg==, figureFileBig=0ZcdAhp00RW9XYDYa0rsGg==, tableContent=null), ArticleFig(id=1324050947965583379, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050943012111337, language=CN, label=图1, caption=2017—2024监测年度病原学检测阳性标本时间分布, figureFileSmall=2VaePY/z09lqNo9JcfIzhg==, figureFileBig=0ZcdAhp00RW9XYDYa0rsGg==, tableContent=null), ArticleFig(id=1324050948234018836, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050943012111337, language=EN, label=Table 1, caption=

ILI surveillance data of Jinhua City, the 2017—2024 surveillance years

, figureFileSmall=null, figureFileBig=null, tableContent=
监测年度
(年)
门急诊就诊数
(例)
ILI数(例)ILI%(%)年龄段(岁)
0~45~1415~2425~59≥60
2017982 17166 1356.7337 55918 9792 1526 514931
20181 049 86944 2754.2229 76212 1814901 566276
2019905 99550 0745.5330 21116 0418212 703298
2020829 71534 5384.1624 0628 503845955173
2021961 53672 6177.5546 05621 3681 9422 920331
2022970 80784 9248.7534 70938 6543 7456 899917
20231 038 90246 5874.4815 79016 5964 3788 845978
20241 009 31426 8632.669 5718 5732 1925 560967
合计7 748 309426 0135.50227 720140 89516 56535 9624 871
), ArticleFig(id=1324050948322099221, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050943012111337, language=CN, label=表1, caption=

2017—2024监测年度金华市ILI监测数据

, figureFileSmall=null, figureFileBig=null, tableContent=
监测年度
(年)
门急诊就诊数
(例)
ILI数(例)ILI%(%)年龄段(岁)
0~45~1415~2425~59≥60
2017982 17166 1356.7337 55918 9792 1526 514931
20181 049 86944 2754.2229 76212 1814901 566276
2019905 99550 0745.5330 21116 0418212 703298
2020829 71534 5384.1624 0628 503845955173
2021961 53672 6177.5546 05621 3681 9422 920331
2022970 80784 9248.7534 70938 6543 7456 899917
20231 038 90246 5874.4815 79016 5964 3788 845978
20241 009 31426 8632.669 5718 5732 1925 560967
合计7 748 309426 0135.50227 720140 89516 56535 9624 871
), ArticleFig(id=1324050948418568214, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050943012111337, language=EN, label=Table 2, caption=

Statistics of ILI% peaks and influenza virus positive rate peaks in Jinhua City, the 2017—2024 surveillance years

, figureFileSmall=null, figureFileBig=null, tableContent=
监测年度
(年)
ILI%高峰病原学阳性率高峰
频次出现季节及时间跨度频次出现季节及时间跨度优势流行毒株
20171冬季,2017年第51周—2018年第8周,共10周,峰值达15.73%2夏季,2017年第29—38周,共10周≥30%A(H3N2)为主兼有少量B/Yamagata系
冬季,2017年第51周—2018年第9周,共11周≥30%初期以B/Victoria系为主,中期以B/Yamagata系和A(H3N2)混合流行为主,后期以A(H1N1) pdm09为主
20181冬季,2019年第2—4周,共3周,峰值达12.91%1冬春季,2019年第1—19周,共19周≥30%初期以A(H3N2)为主,中期为A(H1N1) pdm09和A(H3N2)混合流行,后期以B/Victoria系为主兼有少量B/Yamagata系
20191冬季,2019年第51周—2020年第4周,共6周,峰值达12.46%1冬季,2019年第52周—2020年第5周,共6周≥30%A(H1N1) pdm09、A(H3N2)和B/Victoria系混合流行
20200无明显的高峰,周ILI%波动于5%上下0仅2021年第5周、11周、12周和13周有零星阳性标本检出均为B/Victoria系
20214春末夏初,2021年第21—25周,共5周,峰值达11.16%3夏季,2021年第28—35周,共8周介于10%~16%之间均为B/Victoria系
夏末秋初,2021年第37—40周,共4周,峰值达10.13%
冬季,2021年第49—52周,共4周,峰值达10.44%秋冬季,2021年第44—50周,共7周介于10%~16%之间均为B/Victoria系
春季,2022年第10—17周,共7周,峰值达11.73%冬春季,2022年第3—8周,共6周维持在20%左右;2022年第9—15周,共7周≥30%。以B/Victoria系为主,末期转为A(H3N2)
20222夏季,2022年第23—29周,共7周,峰值达12.09%2春末和夏季,2022年第19—30周,共12周≥30%。均为A(H3N2)
冬末春初,2023年第9—13周,共5周,峰值达29.49%冬末春初,2023年第8—15周,共8周≥30%A(H3N2)和A(H1N1) pdm09混合流行
20231冬季,2023年第49周—2024年第3周,共7周,峰值达10.24%1秋冬季,2023年第44周—2024年7周,共16周≥30%前半期以A(H3N2)为主,后半期以B/Victoria系为主。
20240无明显高峰,周ILI%波动于3%上下1冬季,2025年第1—8周,共8周≥30%A(H1N1) pdm09为主
), ArticleFig(id=1324050948498259991, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050943012111337, language=CN, label=表2, caption=

2017—2024监测年度金华市ILI%高峰和流感病原学阳性率高峰情况统计

, figureFileSmall=null, figureFileBig=null, tableContent=
监测年度
(年)
ILI%高峰病原学阳性率高峰
频次出现季节及时间跨度频次出现季节及时间跨度优势流行毒株
20171冬季,2017年第51周—2018年第8周,共10周,峰值达15.73%2夏季,2017年第29—38周,共10周≥30%A(H3N2)为主兼有少量B/Yamagata系
冬季,2017年第51周—2018年第9周,共11周≥30%初期以B/Victoria系为主,中期以B/Yamagata系和A(H3N2)混合流行为主,后期以A(H1N1) pdm09为主
20181冬季,2019年第2—4周,共3周,峰值达12.91%1冬春季,2019年第1—19周,共19周≥30%初期以A(H3N2)为主,中期为A(H1N1) pdm09和A(H3N2)混合流行,后期以B/Victoria系为主兼有少量B/Yamagata系
20191冬季,2019年第51周—2020年第4周,共6周,峰值达12.46%1冬季,2019年第52周—2020年第5周,共6周≥30%A(H1N1) pdm09、A(H3N2)和B/Victoria系混合流行
20200无明显的高峰,周ILI%波动于5%上下0仅2021年第5周、11周、12周和13周有零星阳性标本检出均为B/Victoria系
20214春末夏初,2021年第21—25周,共5周,峰值达11.16%3夏季,2021年第28—35周,共8周介于10%~16%之间均为B/Victoria系
夏末秋初,2021年第37—40周,共4周,峰值达10.13%
冬季,2021年第49—52周,共4周,峰值达10.44%秋冬季,2021年第44—50周,共7周介于10%~16%之间均为B/Victoria系
春季,2022年第10—17周,共7周,峰值达11.73%冬春季,2022年第3—8周,共6周维持在20%左右;2022年第9—15周,共7周≥30%。以B/Victoria系为主,末期转为A(H3N2)
20222夏季,2022年第23—29周,共7周,峰值达12.09%2春末和夏季,2022年第19—30周,共12周≥30%。均为A(H3N2)
冬末春初,2023年第9—13周,共5周,峰值达29.49%冬末春初,2023年第8—15周,共8周≥30%A(H3N2)和A(H1N1) pdm09混合流行
20231冬季,2023年第49周—2024年第3周,共7周,峰值达10.24%1秋冬季,2023年第44周—2024年7周,共16周≥30%前半期以A(H3N2)为主,后半期以B/Victoria系为主。
20240无明显高峰,周ILI%波动于3%上下1冬季,2025年第1—8周,共8周≥30%A(H1N1) pdm09为主
), ArticleFig(id=1324050948573757464, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050943012111337, language=EN, label=Table 3, caption=

Etiological detection results of influenza virus in ILI cases of Jinhua City, the 2017—2024 surveillance years

, figureFileSmall=null, figureFileBig=null, tableContent=
监测年度
(年)
检测标本数阳性数阳性率(%)流感病毒型别及构成比(%)
A(H1N1) pdm09A(H3N2)B/VictoriaB/Yamagata混合型
20172 08655026.37148(26.91)263(47.82)101(18.36)34(6.18)4(0.73)
20182 08534816.69202(58.05)132(37.93)12(3.45)2(0.57)0(0.00)
20192 08534816.6968(19.54)82(23.56)192(55.17)6(1.72)0(0.00)
20202 46870.280(0.00)0(0.00)7(100.00)0(0.00)0(0.00)
20212 68430211.250(0.00)32(10.60)270(89.40)0(0.00)0(0.00)
20222 64960422.80207(34.27)382(63.25)15(2.48)0(0.00)0(0.00)
20232 24457825.7654(9.34)320(55.36)200(34.60)0(0.00)4(0.69)
20242 61028811.03237(82.29)26(9.03)25(8.68)0(0.00)0(0.00)
合计18 9113 02516.00916(30.28)1237(40.89)822(27.17)42(1.39)8(0.26)
), ArticleFig(id=1324050948666032153, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050943012111337, language=CN, label=表3, caption=

2017—2024监测年度金华市ILI病例流感病毒病原学检测结果

, figureFileSmall=null, figureFileBig=null, tableContent=
监测年度
(年)
检测标本数阳性数阳性率(%)流感病毒型别及构成比(%)
A(H1N1) pdm09A(H3N2)B/VictoriaB/Yamagata混合型
20172 08655026.37148(26.91)263(47.82)101(18.36)34(6.18)4(0.73)
20182 08534816.69202(58.05)132(37.93)12(3.45)2(0.57)0(0.00)
20192 08534816.6968(19.54)82(23.56)192(55.17)6(1.72)0(0.00)
20202 46870.280(0.00)0(0.00)7(100.00)0(0.00)0(0.00)
20212 68430211.250(0.00)32(10.60)270(89.40)0(0.00)0(0.00)
20222 64960422.80207(34.27)382(63.25)15(2.48)0(0.00)0(0.00)
20232 24457825.7654(9.34)320(55.36)200(34.60)0(0.00)4(0.69)
20242 61028811.03237(82.29)26(9.03)25(8.68)0(0.00)0(0.00)
合计18 9113 02516.00916(30.28)1237(40.89)822(27.17)42(1.39)8(0.26)
), ArticleFig(id=1324050950360530970, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050943012111337, language=EN, label=Table 4, caption=

Spearman correlation analysis between ILI% and influenza virus positive rate, the 2017—2024 surveillance years

, figureFileSmall=null, figureFileBig=null, tableContent=
监测年度
(年)
周次数r值P值相关性
2017520.502<0.001正相关
2018520.548<0.001正相关
2019520.613<0.001正相关
2020530.1220.385无相关
202152-0.1350.340无相关
2022520.836<0.001正相关
2023520.840<0.001正相关
2024520.2370.091无相关
), ArticleFig(id=1324050950440222747, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050943012111337, language=CN, label=表4, caption=

2017—2024监测年度ILI%和流感病原学阳性率Spearman相关性分析

, figureFileSmall=null, figureFileBig=null, tableContent=
监测年度
(年)
周次数r值P值相关性
2017520.502<0.001正相关
2018520.548<0.001正相关
2019520.613<0.001正相关
2020530.1220.385无相关
202152-0.1350.340无相关
2022520.836<0.001正相关
2023520.840<0.001正相关
2024520.2370.091无相关
), ArticleFig(id=1324050950515720220, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050943012111337, language=EN, label=Table 5, caption=

Detection of influenza virus in ILI cases by gender and age in Jinhua City, the 2017—2024 surveillance years

, figureFileSmall=null, figureFileBig=null, tableContent=
组别检测标本数阳性份数阳性率(%)流感病毒型别及构成比(%)
A(H1N1) pdm09A(H3N2)B/VictoriaB/Yamagata混合型
性别
男10 1941 67216.40491(29.37)691(41.33)465(27.81)20(1.20)5(0.30)
女8 7171 35315.52425(31.41)546(40.35)357(26.39)22(1.63)3(0.22)
年龄组(岁)
0~45 74165411.39249(38.07)268(40.98)126(19.27)10(1.53)1(0.15)
5~144 05983320.52240(28.81)333(39.98)235(28.21)20(2.40)5(0.60)
15~242 35039316.7298(24.94)195(49.62)100(25.45)0(0.00)0(0.00)
25~595 7621 03517.96278(26.86)390(37.68)354(34.20)11(1.06)2(0.19)
≥6099911011.0151(46.36)51(46.36)7(6.36)1(0.91)0(0.00)
), ArticleFig(id=1324050950616383517, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050943012111337, language=CN, label=表5, caption=

2017—2024监测年度金华市不同性别和年龄ILI流感病毒检出情况

, figureFileSmall=null, figureFileBig=null, tableContent=
组别检测标本数阳性份数阳性率(%)流感病毒型别及构成比(%)
A(H1N1) pdm09A(H3N2)B/VictoriaB/Yamagata混合型
性别
男10 1941 67216.40491(29.37)691(41.33)465(27.81)20(1.20)5(0.30)
女8 7171 35315.52425(31.41)546(40.35)357(26.39)22(1.63)3(0.22)
年龄组(岁)
0~45 74165411.39249(38.07)268(40.98)126(19.27)10(1.53)1(0.15)
5~144 05983320.52240(28.81)333(39.98)235(28.21)20(2.40)5(0.60)
15~242 35039316.7298(24.94)195(49.62)100(25.45)0(0.00)0(0.00)
25~595 7621 03517.96278(26.86)390(37.68)354(34.20)11(1.06)2(0.19)
≥6099911011.0151(46.36)51(46.36)7(6.36)1(0.91)0(0.00)
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2017—2024监测年度浙江省金华市流感样病例流行病学及病原学监测结果分析
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庞志峰 , 钱丽燕 , 龙智平 , 张鹏鸿 , 章光明
现代预防医学 | 卫生监督 2026,53(9): 1710-1716
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现代预防医学 |卫生监督 2026 , 53 (9) : 1710 -1716
2017—2024监测年度浙江省金华市流感样病例流行病学及病原学监测结果分析
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庞志峰, 钱丽燕, 龙智平, 张鹏鸿, 章光明
作者信息
  • 金华市疾病预防控制中心,浙江 金华 321002
通讯作者:
章光明,E-mail:
作者简介:

庞志峰(1980—),男,本科,主任医师,研究方向:急性传染病预防控制工作

Epidemiological and etiological surveillance of influenza-like illness in Jinhua City, Zhejiang Province during the 2017—2024 surveillance years
Zhi-feng PANG, Li-yan QIAN, Zhi-ping LONG, Peng-hong ZHANG, Guang-ming ZHANG
Affiliations
  • Jinhua Municipal Center for Disease Control and Prevention, Jinhua, Zhejiang 321002, China
出版时间: 2026-05-10 doi: 10.20043/j.cnki.MPM.202601244
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目的

分析2017—2024监测年度浙江省金华市流感样病例(influenza-like illness,ILI)流行病学及病原学特征,为流感防控提供科学依据。

方法

通过中国流感监测信息系统,收集金华市2017—2024监测年度(当年第14周—次年第13周)ILI哨点监测数据,采用描述流行病学方法进行分析。

结果

2017—2024监测年度共报告门急诊病例7 748 309例,其中ILI 426 013例,总体ILI就诊百分比(ILI%)为5.50%,2022年度最高,为8.75%,2024年度最低,为2.66%。年度间ILI%波动较大:2017—2019年度为单一冬季高峰,2021年度呈“跨季节多高峰”特征,2022年度为夏季与冬末春初双高峰,2023年度回归为单一冬季高峰,2020与2024年度无显著高峰。ILI集中在0~4岁组,占53.45%。病原学检测18 911份,阳性3 025份,总阳性率为16.00%;甲型、乙型流感病毒分别占71.17%和28.56%。不同亚型构成为:A(H3N2)占40.89%,A(H1N1)pdm09占30.28%,B/Victoria系占27.17%,B/Yamagata系占1.39%且自2020监测年度之后未有检出,混合型占0.26%。ILI%与流感病毒病原阳性率在2017、2018、2019、2022及2023监测年度均呈显著正相关(P<0.001)。

结论

2017—2024监测年度金华市流感活动呈现一定的季节波动和年度差异,新型冠状病毒感染非药物干预措施实施期间流感活动受抑,措施解除后出现反弹。各监测年度优势毒株交替流行,以A(H3N2)占比最高,B/Yamagata系自2020年后未再检出。需进一步优化流感哨点监测体系,强化多病原联合监测和数据整合分析,为流感精准防控提供科学依据。

流行性感冒  /  流感样病例  /  哨点监测  /  病原学
Objective

To analyze the epidemiological and etiological characteristics of influenza-like illness (ILI) in Jinhua City, Zhejiang Province, during the 2017—2024 surveillance years, and to provide a scientific basis for influenza prevention and control in the city.

Methods

ILI surveillance data from sentinel hospitals in Jinhua City during 2017—2024 surveillance years (from week 14 of the current year to week 13 of the following year) were collected through the Chinese Influenza Surveillance Information System and analyzed using descriptive epidemiological methods.

Results

During the 2017—2024 surveillance years, a total of 7 748 309 outpatient and emergency visits were reported, including 426 013 ILI cases, with an overall ILI proportion (ILI%) of 5.50%. The highest ILI% was observed in the 2022 surveillance year (8.75%), while the lowest was recorded in the 2024 surveillance year (2.66%). Marked inter-annual fluctuations in ILI activity were noted: single winter peaks occurred in the 2017—2019 surveillance years. The 2021 surveillance year exhibited multiple cross-seasonal peaks. The 2022 surveillance year showed two peaks, one in summer and the other in late winter and early spring. A single winter peak reappeared in the 2023 surveillance year, and no significant epidemic peaks were detected in the 2020 or 2024 surveillance years. ILI cases were predominantly concentrated in the 0-4 years age group, accounting for 53.45% of all reported cases. A total of 18 911 ILI specimens were tested for influenza virus, of which 3 025 were positive, yielding an overall positive rate of 16.00%. Influenza A and B viruses accounted for 71.17% and 28.56% of positive detections, respectively. Among the identified subtypes and lineages, A (H3N2) accounted for 40.89%, followed by A (H1N1) pdm09 (30.28%), B/Victoria lineage (27.17%), and B/Yamagata lineage (1.39%). No B/Yamagata virus was detected after the 2020 surveillance year. Mixed infections accounted for 0.26%. The ILI% was significantly positively correlated with the influenza virus positivity rate in the 2017, 2018, 2019, 2022, and 2023 surveillance years (P<0.001).

Conclusion

Influenza activity in Jinhua City during the 2017—2024 surveillance years exhibited distinct seasonal fluctuations and pronounced inter-annual variability. Influenza activity was markedly suppressed during the implementation of non-pharmaceutical interventions (NPIs) against COVID-19 and rebounded following their relaxation. The predominant strains alternated across surveillance years, with A (H3N2) accounting for the highest proportion, while B/Yamagata lineage was no longer detected after 2020. Further optimization of the influenza sentinel surveillance system, including strengthening multi-pathogen co-surveillance and integrated data analysis, is needed to provide scientific evidence for precision influenza prevention and control.

Influenza  /  Influenza-like illness  /  Sentinel surveillance  /  Etiology
庞志峰, 钱丽燕, 龙智平, 张鹏鸿, 章光明. 2017—2024监测年度浙江省金华市流感样病例流行病学及病原学监测结果分析. 现代预防医学, 2026 , 53 (9) : 1710 -1716 . DOI: 10.20043/j.cnki.MPM.202601244
Zhi-feng PANG, Li-yan QIAN, Zhi-ping LONG, Peng-hong ZHANG, Guang-ming ZHANG. Epidemiological and etiological surveillance of influenza-like illness in Jinhua City, Zhejiang Province during the 2017—2024 surveillance years[J]. Modern Preventive Medicine, 2026 , 53 (9) : 1710 -1716 . DOI: 10.20043/j.cnki.MPM.202601244
流行性感冒(简称流感)是由流感病毒引起的急性呼吸道传染病,具有传播迅速、抗原易变异、人群普遍易感等特点,一般认为自1918年以来已发生4次全球流感大流行[1],给人类健康造成巨大威胁。据世界卫生组织统计,全球每年约有10亿人感染流感,其中重症病例达300~500万,导致29~65万例呼吸道相关死亡[2]。在我国,不同研究所报道的流感相关年均超额死亡数存在一定差异。发表于2019年的一项研究显示,2010—2015年我国流感年均超额死亡为8.8万例[3];2021年发表的一项覆盖2006—2019年的研究也给出了相近的估计,年均约9万例[4]。一项发表于2024年的研究则揭示,在更广泛的疾病终点下,2012—2021年我国年均流感相关超额死亡人数达20.17万例,年均超额死亡率为14.53/10万,其中以呼吸系统和心血管系统疾病占比最高[5]。
流感有一定的季节性流行特征,但不同地区、不同年份的流行规律及流行株的类型又有所不同,常见的甲型和乙型流感病毒都具有明显的季节性流行特点,容易引起小范围或者全球性的流感大流行。2019年底新型冠状病毒感染疫情的暴发及后续实施的大规模非药物干预措施(non-pharmaceutical interventions,NPIs),对以流感为代表的呼吸道传染病造成了显著影响[6-8],实施NPIs后全球范围内流感活动水平呈“断崖式下降”[9]。然而,NPIs造成的流感传播减少以及由此导致的“免疫负债”,加速了人群中易感者的积累[10]。在NPIs解除后,全球多个国家监测到流感疫情的反弹[11],具体表现为流行强度的升高和季节性特征的改变,如我国在2023年3月出现了春季流感暴发[12],比典型的冬春季流行模式延迟了大约两个月,其峰值也超过了此前所有流行季。
基于上述背景,本研究对2017—2024监测年度金华市流感哨点医院流感样病例(influenza-like illness,ILI)监测数据与病原学监测结果进行了回顾性分析,以期掌握该市流感的流行特征及病原谱变迁规律,为今后流感防控工作提供数据支撑。
数据来源于中国流感监测信息系统,收集2017年第14周至2024年第13周金华市二家国家级流感监测哨点医院(永康市第一人民医院和义乌市中心医院)ILI监测数据和流感监测网络实验室(金华市和义乌市疾病预防控制中心)录入的病原学监测数据。
ILI指发热(体温≥38℃),伴咳嗽或咽痛之一者。ILI就诊百分比(ILI%)指监测诊室ILI数占同期门急诊就诊总数的比例。监测年度定义为当年第14周至次年第13周,如2017监测年度时间范围是2017年第14周至2018年第13周。病原学阳性率为流感病毒核酸阳性数占检测总数的百分比。
在哨点医院的内科门诊、内科急诊、发热门诊和(或)儿内科门诊、儿内科急诊开展ILI监测。哨点医院每周采集5~20例ILI上呼吸道样本,样本采集后在2~8℃条件下于48 h内送至网络实验室,网络实验室72 h内采用实时荧光定量聚合酶链式反应(real-time quantitative PCR,RT-PCR)法检测流感病毒核酸并分型。
数据汇总和图表制作使用Excel 2016软件,数据分析使用R 4.5.2软件。率的比较采用χ2检验,检验水准α=0.05;相关性分析采用Spearman秩相关。
2017—2024监测年度,金华市二家哨点医院共报告门急诊病例7 748 309例,其中ILI 426 013例,总体ILI%为5.50%;2022年度最高,为8.75%;2024年度最低,为2.66%。ILI人群监测结果显示,0~4岁组人群最多,共计227 720例,占53.45%;其次为5~14岁组,共计140 895例,占33.07%;≥60岁组最少,总计4 871例,占1.14%。见表1。
每个监测年度的ILI%高峰出现时间和频次略有不同,但整体上多出现在冬春季,高峰频次多为1~2次。2017年度出现1个ILI%高峰,在2017年第51—52周和次年的第1—8周,峰值达15.73%。2018年度出现1个ILI%高峰,在2019年的第2—4周,峰值达12.91%。2019年度出现1个ILI%高峰,在2019年第51—52周和次年的1—4周,峰值达12.46%。2020年度无明显的高峰,周ILI%波动于5%上下。2021年度出现了4个ILI%高峰,前3个分别集中在2021年的第21—25周、37—40周、49—52周,峰值分别达11.16%、10.13%、10.44%;第4个高峰跨越了两个监测年度,出现在2022年第10—17周,峰值达11.73%。2022年度,除2022年第14—17周延续上一监测年度的发病高峰外,还分别在2022年第23—29周和2023年第9—13周各出现一个高峰,峰值分别达12.09%和29.49%。2023年度仅出现一个ILI%高峰,在2023年第49—52周和次年第1—3周,峰值达10.24%。2024年度无明显高峰,周ILI%波动于3%上下。见表2。
2017—2024监测年度共检测ILI标本18 911份,检出流感病毒阳性标本3 025份,阳性率为16.00%。2017、2022及2023三个监测年度阳性率均高于20%,分别为26.37%、22.80%和25.76%;2018、2019、2021三个监测年度阳性率介于10%~20%,分别为16.69%、16.69%和11.25%;2020年阳性率最低,仅0.28%;不同监测年度阳性率差异有统计学意义(χ2=970.396,P<0.001)。在不同型别流感病毒阳性标本中,甲型流感2 153份,占71.17%;乙型流感864份,占28.56%;混合型8份,占0.26%。在不同亚型流感病毒阳性标本中,A(H3N2)占比最高,为40.89%;其次为A(H1N1) pdm09和B/Victoria系,分别占30.28%和27.17%;B/Yamagata系占比最低,仅1.39%,且自2020监测年度之后未有检出。见表3。
以周为单位对ILI%和流感病原学阳性率进行Spearman秩相关分析,结果显示:2017、2018、2019、2022及2023监测年度ILI%和流感病原学阳性率呈现正相关,2020、2021和2024监测年度无相关性。见表4。
2017—2024监测年度,共计出现11个ILI标本流感病原学阳性率高峰,分布在除2020年以外的7个监测年度,其中2018、2019、2023及2024监测年度各有1个高峰,2017和2022监测年度各有2个高峰,2021监测年度有3个高峰。病原学阳性率高峰多出现在冬春季,一般始于每年的12月终于次年的3月,少数年份终于次年的4月或5月,形成跨监测年度高峰;2017和2021监测年度除冬春季高峰外,还于7—9月各出现一个夏季高峰。ILI标本流感病原学阳性率高峰持续时间最短5周,最长19周,平均10.9周。2021监测年度前2个高峰及第3个高峰早期各周的阳性率低于20%,流行毒株单一且均为B/Victoria系;其余8个高峰各周的阳性率均高于30%,最高达80%左右,流行株呈2种或2种以上亚型流感病毒混合流行或交替流行。见图1和表2。
检测的标本中,男性、女性标本阳性率分别为16.40%和15.52%,差异无统计学意义(χ2=2.711,P=0.100)。各年龄组标本阳性率依次为0~4岁组11.39%,5~14岁组20.52%,15~24岁组16.72%,25~59岁组17.96%,≥60岁组11.01%,差异具有统计学意义(χ2=188.442,P<0.001)。见表5。
研究结果显示:2017—2024各监测年度金华市ILI%波动较大,呈“高-低-高-低”变化趋势。ILI%较高的年份,通常会出现1个以上ILI%高峰,但不同年度ILI%高峰出现的时间以及频次也不尽相同,2017—2019监测年度每年1个ILI%高峰且均出现在冬季;2021监测年度则出现4个ILI%高峰,呈现“跨季节多高峰”特征;2022监测年度为夏季与冬末春初双高峰;2023监测年度又回归冬季单一高峰模式。与之形成对比的是,2020和2024两个监测年度的ILI%均处于较低水平,全年未出现明显的ILI%高峰。年度间ILI%的波动及其季节性特征,一方面与流感病毒及其他呼吸道病原的活动强度直接相关,另一方面也与NPIs的实施、聚集状态改变及人群免疫水平变化等因素密切关联[10,13-14]。
本研究发现,金华市ILI%高峰与流感病原学阳性率高峰之间存在关联性与分离性并存的现象。在2017、2018、2019、2022及2023监测年度,两者呈中至高度正相关(r=0.502~0.840),且流行高峰期间阳性率多≥30%,说明在典型流行季ILI%能够较好反映流感病毒活动水平,具有较高的监测指示价值。然而,在2020、2021及2024监测年度,两者相关性减弱甚至消失,表现为ILI%高峰与流感病原学阳性率高峰错位或单独存在,提示在流感活动低位或受干扰的年份,ILI%指示作用减弱。出现上述关联不一致的可能原因有:(1)一次流感流行后,人群免疫状态较高,虽然出现了流感病毒的活跃,但人群整体感染率低,ILI%高峰难以出现;(2)ILI定义涵盖多种病原体感染,流感病毒与非流感呼吸道病原体在流行时序上重叠或交替,导致ILI%波动受多种病原共同影响[15-16]。
ILI病例主要集中于15岁以下人群,青壮年与老年人占比相对较低,这一分布特征与多数报道结论一致[17-20]。该现象可能与以下几方面因素有关:一是,0~4岁婴幼儿免疫系统尚未完全成熟,抵抗力相对较弱;二是,5~14岁儿童多处于幼儿园或学校等人员密集场所,暴露于病原体的机会显著增加;三是,婴幼儿和学龄儿童感染后临床症状通常较为明显,家长重视程度高,就诊意愿强,也推高了该群体的ILI报告比例[21]。与之相比,≥60岁组病例占比最低(1.14%),主要与老年人感染后症状不典型、主动就诊率较低有关[22]。然而,这一现象也可能在一定程度上低估老年人群的实际感染负担,今后需结合严重急性呼吸道感染监测数据进一步综合评估。
病原学监测结果显示,除2020年监测年度外,金华市其他年度均有不同型别流感病毒检出,呈现单一亚型交替流行或多种亚型混合流行的特征。在同一监测年度甚至是同一流行季,优势毒株会随时间发生型别转换,提示流感优势毒株的易变性以及变异的不可预知性,需进一步强化监测以准确掌握病原谱变迁特征。2017—2024监测年度金华市甲型流感病毒流行强度强于乙型,A(H3N2)亚型多于A(H1N1) pdm09亚型和B/Victoria系。自2020监测年度之后,该市没有B/Yamagata系的检出,与全球趋势一致[11]。有研究认为,与其他型别流感病毒相比,B/Yamagata系流感病毒的抗原多样性低、再生指数低、传播链短等特点,使之更容易受NPIs影响而导致其功能性灭绝[23-24]。
本研究也存在一定局限。一方面,ILI作为一个涵盖多病原体的症候群,本文仅针对流感病毒进行分析,未评估其他常见呼吸道病原体的协同或竞争作用;另一方面,ILI%监测数据来源于手工填报,可能存在信息偏倚与随机误差,影响趋势判断的精确度。未来若能整合多病原实验室检测数据,并实现医院信息系统数据的自动抓取,将有助于构建更全面、客观的呼吸道传染病监测与预警体系。
  • 金华市科技计划项目(2025-4-167)
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2026年第53卷第9期
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doi: 10.20043/j.cnki.MPM.202601244
  • 接收时间:2026-01-14
  • 首发时间:2026-11-02
  • 出版时间:2026-05-10
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  • 收稿日期:2026-01-14
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金华市科技计划项目(2025-4-167)
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    金华市疾病预防控制中心,浙江 金华 321002

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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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