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Article(id=1241522773886038860, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522764012647140, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202308031, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1690992000000, receivedDateStr=2023-08-03, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773931695671, onlineDateStr=2026-03-19, pubDate=1704816000000, pubDateStr=2024-01-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773931695671, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773931695671, creator=13701087609, updateTime=1773931695671, updator=13701087609, issue=Issue{id=1241522764012647140, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='1', pageStart='1', pageEnd='192', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773931693318, creator=13701087609, updateTime=1773931808852, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241523248643494379, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522764012647140, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241523248643494380, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522764012647140, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=156, endPage=160, ext={EN=ArticleExt(id=1241522775064638302, articleId=1241522773886038860, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of influenza sentinel surveillance results in Sichuan Province from 2020 to 2022, columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the results of influenza sentinel surveillance in Sichuan Province from 2020 to 2022, to provide basis for influenza prevention and control in Sichuan.

Methods

The surveillance data of influenza-like illness (ILI) reported by 30 national influenza surveillance sentinel hospitals in Sichuan Province were collected through China Influenza Surveillance Information System, and the results of influenza sentinel surveillance in Sichuan Province from 2020 to 2022 were analyzed retrospectively by descriptive epidemiological methods.

Results

From 2020 to 2022, there was a correlation between the proportion of ILI to the total number of outpatient and emergency surveillance cases (ILI%) and the detection rate of influenza in ILI samples (rs=0.626, P < 0.001). From 2020 to 2022, a total of 103 544 influenza samples were collected and tested in Sichuan Province, of which 8 798 were tested positive, with a positive rate of 8.50%. In 2020, the epidemic level of influenza in Sichuan Province was low, and the epidemic peak was in January, which was co-epidemic of subtype A (H3N2) and strain B (Victoria). In 2021, the epidemic peak was in autumn and winter, and the dominant strain was strain B (Victoria). In 2022, there was an obvious summer epidemic peak in Sichuan Province, and the dominant strain was subtype A (H3N2). There were significant differences in the positive rate of ILI among different years, age groups, and cities and states (P<0.001).

Conclusion

Influenza B (Yamagata) was not detected in Sichuan Province from 2020 to 2022, and the main epidemic strain were A(H3N2) and B(Victoria). The epidemic strains in Sichuan Province displayed decreased epidemic levels at the end of 2020 and 2022, which may be attributed to the COVID-19 preventive and control efforts and the occurrence of viral interference. It is necessary to continue influenza surveillance and strengthen the prevention and control of influenza in children and students.

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目的

分析2020—2022年四川省流感哨点监测结果，为全省流感疫情防控提供依据。

方法

通过中国流感监测信息系统，收集四川省30家国家级流感监测哨点医院报告的流感样病例（influenza-like illness，ILI）监测数据，采用描述性流行病学方法对四川省2020—2022年流感哨点监测结果进行回顾性分析。

结果

2020—2022年全省各月ILI占门急诊监测诊室就诊病例总数的比例（ILI%）与ILI标本流感检测阳性率之间存在相关性（rs=0.626，P<0.001）。2020—2022年，四川省共采集并检测流感样病例标本103 544份，其中阳性标本8 798份，阳性率8.50%。2020年四川省流感流行水平较低，流行高峰在1月，为A(H3N2)亚型和B(Victoria)系共同流行；2021年流行高峰在秋冬季，优势流行株为B(Victoria)系；2022年四川省出现明显的夏季流行高峰，优势株为A(H3N2)亚型。流感样病例标本阳性检出率，在各年度间、各年龄组间和各市州间均存在统计学差异（P<0.001）。

结论

四川省2020—2022年均未监测B(Yamagata)系流感病毒，主要流行株为A(H3N2)和B(Victoria)系。2020和2022年底流感流行水平较低，可能与新冠防控各项措施及病毒的干扰现象有关，需持续做好流感监测工作并加强儿童学生流感的防控工作。

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肖崇堃，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=1PMMcCS75vvRtYR0GTj6aw==, magXml=OR+nBoStEujSvej0nM3QPA==, pdfUrl=null, pdf=kr0mMLSS0ky49bl6vnwYHA==, pdfFileSize=3621386, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=CgMiqSf/dSzbz+U9plOc5g==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=w5ehd0Wldkx+3HiEz8v52g==, mapNumber=null, authorCompany=null, fund=null, authors=

周丽君（1986—），女，硕士，副主任医师，研究方向：呼吸道疾病防控

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周丽君（1986—），女，硕士，副主任医师，研究方向：呼吸道疾病防控

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周丽君（1986—），女，硕士，副主任医师，研究方向：呼吸道疾病防控

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Influenza laboratory surveillance information virus detections by subtype reported to flunet[EB/OL].[2023-12-10]. https://www.who.int/tools/flunet/flunet-summary., articleTitle=Influenza laboratory surveillance information virus detections by subtype reported to flunet, refAbstract=null)], funds=[Fund(id=1241677617775047446, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522773886038860, awardId=2023JDR0256, language=CN, fundingSource=基于互联网大数据的新发和重大传染病暴发疫情早期预警机制研究(2023JDR0256), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241677609281581553, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522773886038860, xref=null, ext=[AuthorCompanyExt(id=1241677609289970162, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522773886038860, companyId=1241677609281581553, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1241677609294164469, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522773886038860, companyId=1241677609281581553, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=四川省疾病预防控制中心，四川 成都 610041)])], figs=[ArticleFig(id=1241677614436381351, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522773886038860, language=EN, label=Figure 1, caption=Time distribution of ILI% and influenza virus positive rate in Sichuan Province from 2020 to 2022, figureFileSmall=wGl/R+ZJiamlCUWBZqHlWw==, figureFileBig=9Hcx5RkSQDhppHdLnHm6MA==, tableContent=null), ArticleFig(id=1241677614553821871, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522773886038860, language=CN, label=图1, caption=四川省2020—2022年ILI%和ILI标本流感阳性率时间分布, figureFileSmall=wGl/R+ZJiamlCUWBZqHlWw==, figureFileBig=9Hcx5RkSQDhppHdLnHm6MA==, tableContent=null), ArticleFig(id=1241677614662873785, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522773886038860, language=EN, label=Figure 2, caption=Distribution of influenza-like illness by age in sentinel hospitals from 2020 to 2022, figureFileSmall=KPQjMY/0cz3IuCxkIJ2XlQ==, figureFileBig=Du0z5omDk5Z0Ohh13UB1tg==, tableContent=null), ArticleFig(id=1241677614792897220, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522773886038860, language=CN, label=图2, caption=四川省2020—2022年哨点医院监测诊室ILI病例分年龄时间分布, figureFileSmall=KPQjMY/0cz3IuCxkIJ2XlQ==, figureFileBig=Du0z5omDk5Z0Ohh13UB1tg==, tableContent=null), ArticleFig(id=1241677614897754826, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522773886038860, language=EN, label=Figure 3, caption=Temporal distribution of influenza virus nucleic acid positive detection in Sichuan from 2020 to 2022, figureFileSmall=OBSzPe3vQ74S2JQjsXNk+w==, figureFileBig=nnNacs8BkDF7ZN/Uq3G+TQ==, tableContent=null), ArticleFig(id=1241677616441258704, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522773886038860, language=CN, label=图3, caption=2020—2022年四川省ILI标本核酸检测结果时间分布, figureFileSmall=OBSzPe3vQ74S2JQjsXNk+w==, figureFileBig=nnNacs8BkDF7ZN/Uq3G+TQ==, tableContent=null), ArticleFig(id=1241677616638391001, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522773886038860, language=EN, label=Figure 4, caption=Distribution of influenza virus positive rate in Sichuan Province from 2020 to 2022, figureFileSmall=0/LCTyZyLosJ6R6CI2hLAQ==, figureFileBig=LloXvIFXqEqHCt9FqZAztg==, tableContent=null), ArticleFig(id=1241677616797774564, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522773886038860, language=CN, label=图4, caption=2020—2022年四川省ILI标本分市州流感检出率分布

注：A为2020年各市州ILI标本流感阳性率；B为2021年各市州ILI标本流感阳性率；C为2022年各市州ILI标本流感阳性率；D为2020—2022年各市州ILI标本流感阳性率；中国标准地图审图号GS(2019)1822号。

, figureFileSmall=0/LCTyZyLosJ6R6CI2hLAQ==, figureFileBig=LloXvIFXqEqHCt9FqZAztg==, tableContent=null), ArticleFig(id=1241677616940380914, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522773886038860, language=EN, label=Table 1, caption=

Influenza virus nucleic acid positive detection in different years from 2020 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）A(H3N2)A(H1N1)B(Victoria)A未分型阳性总数检测数阳性率
（%）
例数构成比（%）例数构成比（%）例数构成比（%）例数构成比（%）
202039247.46323.8740048.4320.2482631 0362.66
202100.0000.004 34899.8660.144 35438 69811.25
20222 87879.5500.0073620.3440.113 61833 81010.70
合计3 27037.17320.365 48462.33120.148 798103 5448.50
), ArticleFig(id=1241677617091375863, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522773886038860, language=CN, label=表1, caption=

2020—2022年四川省哨点监测ILI标本核酸检测情况

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）A(H3N2)A(H1N1)B(Victoria)A未分型阳性总数检测数阳性率
（%）
例数构成比（%）例数构成比（%）例数构成比（%）例数构成比（%）
202039247.46323.8740048.4320.2482631 0362.66
202100.0000.004 34899.8660.144 35438 69811.25
20222 87879.5500.0073620.3440.113 61833 81010.70
合计3 27037.17320.365 48462.33120.148 798103 5448.50
), ArticleFig(id=1241677617229787901, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522773886038860, language=EN, label=Table 2, caption=

Influenza virus nucleic acid positive detection in different age groups from 2020 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄组
（岁）		A(H3N2)A(H1N1)B(Victoria)A未分型阳性总数检测数阳性率
（%）
例数构成比（%）例数构成比（%）例数构成比（%）例数构成比（%）
0～490144.8350.251 09754.5870.352 01047 5524.23
5～141 18033.3030.082 35966.5620.063 54425 30814.00
15～2435233.8540.3868465.7700.001 0409 58910.85
25～5969334.93170.861 27164.0630.151 98416 55311.99
≥6014465.4531.367333.1800.002204 5424.84
合计3 27037.17320.365 48462.33120.148 798103 5448.50
), ArticleFig(id=1241677617393365761, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522773886038860, language=CN, label=表2, caption=

2020—2022年四川省哨点监测ILI标本分年龄组核酸检测情况

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄组
（岁）		A(H3N2)A(H1N1)B(Victoria)A未分型阳性总数检测数阳性率
（%）
例数构成比（%）例数构成比（%）例数构成比（%）例数构成比（%）
0～490144.8350.251 09754.5870.352 01047 5524.23
5～141 18033.3030.082 35966.5620.063 54425 30814.00
15～2435233.8540.3868465.7700.001 0409 58910.85
25～5969334.93170.861 27164.0630.151 98416 55311.99
≥6014465.4531.367333.1800.002204 5424.84
合计3 27037.17320.365 48462.33120.148 798103 5448.50
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2020—2022年四川省流感哨点监测结果分析
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周丽君 , 董爽 , 李知睿 , 袁珩 , 周兴余 , 胡风淼 , 肖崇堃
现代预防医学 | 疾病预防控制 2024,51(1): 156-160
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现代预防医学 | 疾病预防控制 2024, 51(1): 156-160
2020—2022年四川省流感哨点监测结果分析
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周丽君, 董爽, 李知睿, 袁珩, 周兴余, 胡风淼, 肖崇堃
作者信息
  • 四川省疾病预防控制中心，四川 成都 610041

    • 周丽君（1986—），女，硕士，副主任医师，研究方向：呼吸道疾病防控

通讯作者:

肖崇堃，E-mail:
Analysis of influenza sentinel surveillance results in Sichuan Province from 2020 to 2022
Li-jun ZHOU, Shuang DONG, Zhi-rui LI, Heng YUAN, Xing-yu ZHOU, Feng-miao HU, Chong-kun XIAO
Affiliations
  • Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 610041, China
出版时间: 2024-01-10 doi: 10.20043/j.cnki.MPM.202308031
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摘要
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目的

分析2020—2022年四川省流感哨点监测结果，为全省流感疫情防控提供依据。

方法

通过中国流感监测信息系统，收集四川省30家国家级流感监测哨点医院报告的流感样病例（influenza-like illness，ILI）监测数据，采用描述性流行病学方法对四川省2020—2022年流感哨点监测结果进行回顾性分析。

结果

2020—2022年全省各月ILI占门急诊监测诊室就诊病例总数的比例（ILI%）与ILI标本流感检测阳性率之间存在相关性（rs=0.626，P<0.001）。2020—2022年，四川省共采集并检测流感样病例标本103 544份，其中阳性标本8 798份，阳性率8.50%。2020年四川省流感流行水平较低，流行高峰在1月，为A(H3N2)亚型和B(Victoria)系共同流行；2021年流行高峰在秋冬季，优势流行株为B(Victoria)系；2022年四川省出现明显的夏季流行高峰，优势株为A(H3N2)亚型。流感样病例标本阳性检出率，在各年度间、各年龄组间和各市州间均存在统计学差异（P<0.001）。

结论

四川省2020—2022年均未监测B(Yamagata)系流感病毒，主要流行株为A(H3N2)和B(Victoria)系。2020和2022年底流感流行水平较低，可能与新冠防控各项措施及病毒的干扰现象有关，需持续做好流感监测工作并加强儿童学生流感的防控工作。

流感样病例  /  哨点监测  /  疾病监测
Objective

To analyze the results of influenza sentinel surveillance in Sichuan Province from 2020 to 2022, to provide basis for influenza prevention and control in Sichuan.

Methods

The surveillance data of influenza-like illness (ILI) reported by 30 national influenza surveillance sentinel hospitals in Sichuan Province were collected through China Influenza Surveillance Information System, and the results of influenza sentinel surveillance in Sichuan Province from 2020 to 2022 were analyzed retrospectively by descriptive epidemiological methods.

Results

From 2020 to 2022, there was a correlation between the proportion of ILI to the total number of outpatient and emergency surveillance cases (ILI%) and the detection rate of influenza in ILI samples (rs=0.626, P < 0.001). From 2020 to 2022, a total of 103 544 influenza samples were collected and tested in Sichuan Province, of which 8 798 were tested positive, with a positive rate of 8.50%. In 2020, the epidemic level of influenza in Sichuan Province was low, and the epidemic peak was in January, which was co-epidemic of subtype A (H3N2) and strain B (Victoria). In 2021, the epidemic peak was in autumn and winter, and the dominant strain was strain B (Victoria). In 2022, there was an obvious summer epidemic peak in Sichuan Province, and the dominant strain was subtype A (H3N2). There were significant differences in the positive rate of ILI among different years, age groups, and cities and states (P<0.001).

Conclusion

Influenza B (Yamagata) was not detected in Sichuan Province from 2020 to 2022, and the main epidemic strain were A(H3N2) and B(Victoria). The epidemic strains in Sichuan Province displayed decreased epidemic levels at the end of 2020 and 2022, which may be attributed to the COVID-19 preventive and control efforts and the occurrence of viral interference. It is necessary to continue influenza surveillance and strengthen the prevention and control of influenza in children and students.

Influenza-like illness  /  Sentinel surveillance  /  Disease surveillance
周丽君, 董爽, 李知睿, 袁珩, 周兴余, 胡风淼, 肖崇堃. 2020—2022年四川省流感哨点监测结果分析. 现代预防医学, 2024 , 51 (1) : 156 -160 . DOI: 10.20043/j.cnki.MPM.202308031
Li-jun ZHOU, Shuang DONG, Zhi-rui LI, Heng YUAN, Xing-yu ZHOU, Feng-miao HU, Chong-kun XIAO. Analysis of influenza sentinel surveillance results in Sichuan Province from 2020 to 2022[J]. Modern Preventive Medicine, 2024 , 51 (1) : 156 -160 . DOI: 10.20043/j.cnki.MPM.202308031
正文
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流感是由于流感病毒感染人体而引起的急性呼吸道传染病，人群对流感病毒普遍易感，对人群健康危害较重。流感病毒可分为甲、乙、丙、丁（即A、B、C、D）四种型别，通常可引起流感季节性流行的病毒为A(H1N1)、A(H3N2)亚型、B(Victoria)系和B(Yamagata)系，其中B(Yamagata)系近三年全球监测到的阳性标本极少[1]。四川省自2009年起建立了覆盖21个市州的流感样病例监测网络，涉及30家国家级流感监测哨点医院和23家网络实验室23家。为了解2020—2022年新冠疫情期间四川省流感病毒流行情况，本文对2020—2022年四川省流感哨点医院及网络实验室监测数据进行分析，了解全省流感流行情况及变化趋势，探讨三年新冠疫情防控下对全省流感流行的影响，为全省流感防控及公共卫生决策提供科学支撑。
1　资料与方法
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1.1　资料来源
本文中监测资料均来源于在“中国流感监测信息系统”中我省报告的ILI数据及ILI标本监测结果。
1.2　流感样病例定义
根据《全国流感监测技术指南（2017年版）》（简称指南），流感样病例（influenza-like illness，ILI）定义为：发热（体温≥38℃），伴咳嗽或咽痛之一者[2]。
1.3　流感样病例监测内容
依据指南要求，国家级流感哨点医院监测诊室（内科门急诊、发热门诊、儿内科门急诊）的医务人员，对每天在上述监测诊室就诊的病例进行诊断，按科室登记相关年龄组的流感样病例数和门急诊病例就诊病例总数，并及时录入“中国流感监测信息系统”。同时每周采集10～40份流感样病例呼吸道标本（咽拭子、鼻拭子或鼻咽拭子），送对应的流感监测网络实验进行流感病毒检测，检测结果录入“中国流感监测信息系统”。
1.4　数据统计及分析
使用Excel 2019对监测数据进行整理，采用描述性流行病学方法对四川省2020—2022年流感哨点监测结果进行分析。统计分析软件为SAS9.4，检验水准α=0.05。ILI%和ILI标本流感检测阳性率之间的相关性采用Spearman秩相关检验；阳性率的差异比较采用χ2检验。
2　结果
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2.1　ILI监测基本情况
2020—2022年，四川省30家国家级流感监测哨点医院所有监测诊室共报告836 870例ILI病例，所有监测诊室门急诊病例就诊总数为23 425 405例，流感样病例占门急诊病例数的百分比（简称ILI%）为3.57%。每月ILI%在2.13%～10.14%之间波动。2020年报告的ILI%为2.9%；2021年报告的ILI%为3.27%；2022年报告的ILI%为4.47%。
2.1.1　ILI%流行趋势
ILI%在2020年1和2月、2021年10和11月，以及2022年6—8月和12月呈现较高水平，分别为3.89%、3.92%、4.16%、4.57%、4.62%～7.38%、10.14%。对2020—2022年全省各月ILI%和ILI标本流感检测阳性率进行Spearman秩相关检验（rs=0.626，P<0.001），两者相关性具有统计学意义。见图1。
2.1.2　ILI年龄分布
2020—2022年，哨点医院监测诊室报告的836 870例ILI病例中，0～4岁组最多，共454 612例，占54.32%；其次为5～14岁组，共197 540例，占23.6%；25～59岁组，共98 196例，占11.73%；15～24岁组，共56 698例，占6.78% ；≥60岁组，共29 824例，占3.56%。见图2。
2.2　病原学检测基本情况
2020—2022年四川省30家国家级哨点医院共采集ILI标本103 544份，所有标本均送至流感网络实验室进行流感病毒核酸检测，共检出8 798份流感阳性标本，阳性检出率为8.50%。2020年四川省采集并检测ILI标本31 036份，检出阳性标本826份，阳性率2.66%；2021年采集并检测ILI标本38 698份，检出阳性标本4 354份，阳性率11.25%；2022年采集并检测ILI标本33 810份，检出阳性标本3 618份，阳性率10.7%。2020—2022年共检出12份流感病毒甲型阳性未分亚型标本，标本经复核后主要为3类阳性亚型：H9N2禽流感、欧亚类禽H1N1猪流感、H5N6禽流感。不同年份阳性率具有统计学差异（χ2=1 948.171，P<0.001）。见表1。
2.2.1　时间趋势
2020年四川省ILI标本流感阳性检出高峰在1月份，以A(H3N2)和B(Victoria)共同流行，共检出757份流感病毒阳性标本，其中A(H3N2)亚型379份、B(Victoria)系351份、A(H1N1)亚型27份，阳性率26.77%，之后流感病毒阳性标本检出极少。2021年秋冬季流感活动水平较高，11月出现检出高峰，共检出1 376份流感阳性标本，均为B(Victoria)系，阳性率38.06%。2022年四川省出现明显的夏季流感流行高峰，7—8月流感阳性标本检出较高，流行毒株为A(H3N2)亚型，阳性率在7月份检出最高，为33.17%。见图3。
2.2.2　年龄分布
2020—2022年哨点医院采集的ILI标本经检测，5～14岁组标本流感病毒核酸阳性检出率最高为14%。后依次为25～59岁组，阳性率11.99%；15～24岁组，阳性率10.85%；≥60岁组，阳性率4.84%；0～4岁组，阳性率4.23%。不同年龄组阳性率具有统计学差异（χ2=2 507.291，P<0.001）。见表2。
2.2.3　地区分布
2020年四川省全省流感流行水平较低，有8个市州全年均未通过哨点医院监测到流感阳性标本，各市州ILI标本流感病毒核酸阳性率在0～0.39%之间。2021和2022年各市州均有流感阳性标本检出，2021年各市州ILI标本流感病毒核酸阳性率在5.95%～19.12%之间，2022年各市州ILI标本流感病毒核酸阳性率在1.69%～18.40%之间。各市州监测阳性率具有统计学差异（χ2=466.688，P<0.001）。见图4。
3　讨论
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流感作为一种常见且频发的呼吸道传染病，每年呈季节性流行，也可能出现流感大流行。过往百年有明确证据的流感大流行共出现过五次，其中WHO定义了四次，累积造成数千万人死亡[3]。由于流感病毒变异较为频繁，目前尚无法预测何种病毒变异可能会导致流感大流行。因此，加强监测、实时追踪流感病毒的变异情况是应对流感大流行的基础。
自2020年新冠疫情防控以来，四川省流感病毒流行规律较往年有所改变，四川省2020年底和2022年底均未出现明显的季节高峰，且2020年四川省多个市州未监测到流感病毒，这与四川省历年的监测结果不一致[4]。2020年流感处于低流行状态，可能与新冠防控相关政策措施及人群个人卫生习惯、防护措施有关[5-8]。有研究显示病毒流行存在“病毒的干扰现象”，即新冠病毒的流行可能会抑制流感等其他呼吸道病毒的感染[9]，这也可能是导致2022年底四川省流感低流行的原因。2022年四川省出现以A（H3N2）亚型为优势流行株的夏季流感高峰，为新冠疫情以来首次出现，可能原因为国外流行的H3N2流感毒株引入国内，进而引起四川省夏季高峰。2021年底至2022年初，WHO监测数据显示，全球各地区除东南亚地区外，均出现了H3N2流感亚型检出高峰。不过，此次四川省出现的夏季流感高发并非特例，已有的研究中，2015年四川省也出现了夏季流感流行[4]，此外其他省份也报到过夏季流感高峰的出现[10]。
监测结果显示，各市州ILI标本阳性率存在统计学差异，通过多年对哨点医院的现场调查，分析原因可能为采样医生对采样对象选择方面存在一定差异，具体原因有待进一步研究。2020—2022年ILI%与流感样病例标本阳性率之间存在相关性，但是ILI%在2022年12月达到最高，同时ILI标本流感病毒检出率极低，提示新冠病毒的流行会对流感监测中的ILI%指标造成影响，在常规ILI%分析时，若出现异常值，需考虑可引起人群出现发热伴呼吸道症状的其他病原体的可能。全省ILI监测数据中，不同年龄组在ILI病例中的占比具有明显差异，2020—2022年15岁以下ILI病例占总报告ILI病例的77.93%，采集了标本的ILI病例也以15岁以下为主，占70.37%，与其他研究一致[11]。可能原因为低年龄儿童或者学生出现相应症状后关注度较高，就诊的可能性更高，因而更易被纳入监测。分年龄组ILI标本流感检出率存在差异，0～4岁组和60岁及以上年龄组ILI标本流感病毒检出率均较低，与有关研究一致[12]。不过低年龄组婴幼儿与老年人作为流感的高危人群，虽然流感病毒检出率较低，但感染后出现重症甚至死亡的风险会更高，需要加强宣传教育，提高流感疫苗在老年人、适龄婴幼儿及看护人员的接种率[1]。
2020—2022年，四川省均未监测到B(Yamagata)系流感病毒，全球流感监测显示2020—2022年B(Yamagata)系检出也极少[13]。通过流感监测网络不仅可以监测季节性流感的活动水平和趋势，还能监测动物流感对人群健康的风险。后续需持续做好流感监测工作，及时反映流感在人群中的流行情况和病毒型别交替情况，为流感防控提供科学的数据支撑。
基金
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  • 基于互联网大数据的新发和重大传染病暴发疫情早期预警机制研究(2023JDR0256)
文献
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2024年第51卷第1期
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doi: 10.20043/j.cnki.MPM.202308031
  • 接收时间：2023-08-03
  • 首发时间：2026-03-19
  • 出版时间：2024-01-10
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  • 收稿日期：2023-08-03
基金
基于互联网大数据的新发和重大传染病暴发疫情早期预警机制研究(2023JDR0256)
作者信息
    四川省疾病预防控制中心，四川 成都 610041

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肖崇堃，E-mail:
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2种不同金属材料的力学参数
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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
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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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