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Article(id=1241771802712671057, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241771801366299468, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202406274, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1718640000000, receivedDateStr=2024-06-18, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773991068770, onlineDateStr=2026-03-20, pubDate=1729785600000, pubDateStr=2024-10-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773991068770, onlineIssueDateStr=2026-03-20, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773991068770, creator=13701087609, updateTime=1773991068770, updator=13701087609, issue=Issue{id=1241771801366299468, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='20', pageStart='3649', pageEnd='3840', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773991068450, creator=13701087609, updateTime=1773991676896, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241774353457681403, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241771801366299468, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241774353457681404, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241771801366299468, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3664, endPage=3671, ext={EN=ArticleExt(id=1241771803085964118, articleId=1241771802712671057, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Epidemiological characteristics and spatiotemporal clustering of influenza, Huanggang, 2014-2023, columnId=null, journalTitle=Modern Preventive Medicine, columnName=null, runingTitle=null, highlight=null, articleAbstract=
Objective

The epidemic situation of influenza from 2014 to 2023 in Huanggang City was analyzed to provide reference for prevention and control of influenza in Huanggang City.

Methods

The data of influenza online report, ILI monitoring data and etiological detection data in Huanggang City from 2014 to 2023 were collected and analyzed.

Results

From 2014 to 2023, the annual incidence of influenza in Huanggang City ranged from 5.38/100,000 (2014) to 1,178.19/100,000 (2023), with a trend of first increasing (2014-2019), then decreasing (2020-2022), and reaching a peak in 2023.Retrospective spatiotemporal scanning analysis showed that the onset time was mainly concentrated in December of each year and January and February of the following year. In the epidemic season, Huangzhou, Luotian and Qichun were the main cluster areas of Class I and Class II. The ILI% value of each year in Huanggang City from 2014 to 2023 ranged from 4.41% to 13.17%, and the difference of ILI% each year was statistically significant (χ2=83 652.46,P<0.01), and the annual change trend was similar to that reported by influenza network.The positive rate of influenza virus in ILI case samples showed the characteristics of peak in winter and spring and small peak in summer, and H3N2, H1N1 and BBV were alternately or co-prevalent in each year and within each year.The analysis of correlation results between ILI% and positive rate of influenza virus showed that: except 2014-2016 and 2020-2022, the other 4 years showed positive correlation, and the P-value was less than 0.05,

Conclusion

The prevalence of influenza in Huanggang showed an increasing trend year by year, with obvious seasonal characteristics and temporal and spatial aggregation. The dominant strains, mainly H1N1, H3N2 and BV, alternated or co-circulated within the year and between different years.

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目的

分析2014—2023年黄冈市流行性感冒（influenza，简称流感）的流行情况，为黄冈市流感防控提供参考依据。

方法

收集2014—2023年黄冈市流感网报数据、ILI监测数据、病原学检测数据进行分析。

结果

2014—2023年黄冈市报告流感各年的发病率在5.38 /10万( 2014年) ~1 178.19/10万( 2023年)之间，变化趋势为先上升（2014—2019年）后下降（2020—2022年），2023年达峰值。回顾性时空扫描分析显示，发病时间主要集中在每年的12月及次年的1月、2月，在流行季节，黄州、罗田、蕲春、武穴是主要的一类和二类聚集区。2014—2023年黄冈市各年度ILI%值在4.41% ~13.17%之间，各个年度ILI%差异有统计学意义（χ2= 83 652.46，P<0.01），年度变化趋势与流感网报情况类似。ILI病例标本流感病毒阳性率整体上呈现冬春季高峰、夏季小高峰的特点，H3N2、H1N1、乙型BV型在各年度及年度内交替或共同流行。ILI%与流感病毒阳性率的相关性结果分析显示：除2014—2016、2020—2022年以外，其余4个年份显示两者正相关，P值均小于0.05，差异有统计学意义。

结论

黄冈市流感流行总体呈逐年上升趋势，发病有明显的季节特征及时空聚集性，以H1N1、H3N2、BV为主的优势毒株在年度内及不同年度间交替或共同流行。

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王芬，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=UH5z3gNsvSNs/Rbs4zAnqg==, magXml=drdqrbGAQPSnkHNn96FWyA==, pdfUrl=null, pdf=oLW+SgBINBPEsGq+QcFFQg==, pdfFileSize=1032482, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=ABcS4zPfY/Ul6Ox7+u27Qg==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=xZzmaqzHtSk/5cwdJGM3Mw==, mapNumber=null, authorCompany=null, fund=null, authors=

陈宇（1992—），女，本科，主治医师，研究方向：临床医学

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陈宇（1992—），女，本科，主治医师，研究方向：临床医学

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陈宇（1992—），女，本科，主治医师，研究方向：临床医学

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Analysis of influenza surveillance results in Anhui Province from 2018 to 2020[J].Anhui Journal of Preventive Medicine, 2021, 27(5): 335-338. 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Analysis of influenza surveillance in Guangxi from 2019 to 2021[J]. Modern Preventive Medicine, 2022, 49(18): 3440-3445. 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Regional distribution of influenza incidence in Huanggang City from 2014 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
地区/年份2014年2015年2016年2017年2018年2019年2020年2021年2022年2023年年均发病率
黄州4.8953.6835.30322.24550.851 985.86305.18107.47212.182 078.96526.72
团风2.0315.044.6793.83263.08582.5478.0137.9492.26534.41200.06
红安4.4614.6515.3847.7596.03242.7841.0435.6798.14573.89124.80
罗田4.356.3344.05267.74482.72893.25182.00103.97582.091 308.61416.64
英山2.229.674.1623.4367.69398.1939.5749.00175.21744.60158.78
浠水1.122.683.7421.2335.15408.33142.6085.86137.151 187.58213.89
蕲春0.949.9923.18221.96176.921 153.50281.8874.99631.291 851.21436.89
黄梅14.2420.0526.7161.2373.61367.84142.0553.95233.71793.09184.23
麻城8.0013.4111.6020.3730.44267.0466.6710.5261.72973.66144.22
武穴6.5215.8722.0048.82100.76340.68219.2610.50187.751 274.74218.24
黄冈市合计5.3814.3918.90100.44155.46602.26151.5254.69249.161 178.19259．21
), ArticleFig(id=1241771815496909092, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771802712671057, language=CN, label=表1, caption=

2014—2023年黄冈市流感发病率地区分布表

, figureFileSmall=null, figureFileBig=null, tableContent=
地区/年份2014年2015年2016年2017年2018年2019年2020年2021年2022年2023年年均发病率
黄州4.8953.6835.30322.24550.851 985.86305.18107.47212.182 078.96526.72
团风2.0315.044.6793.83263.08582.5478.0137.9492.26534.41200.06
红安4.4614.6515.3847.7596.03242.7841.0435.6798.14573.89124.80
罗田4.356.3344.05267.74482.72893.25182.00103.97582.091 308.61416.64
英山2.229.674.1623.4367.69398.1939.5749.00175.21744.60158.78
浠水1.122.683.7421.2335.15408.33142.6085.86137.151 187.58213.89
蕲春0.949.9923.18221.96176.921 153.50281.8874.99631.291 851.21436.89
黄梅14.2420.0526.7161.2373.61367.84142.0553.95233.71793.09184.23
麻城8.0013.4111.6020.3730.44267.0466.6710.5261.72973.66144.22
武穴6.5215.8722.0048.82100.76340.68219.2610.50187.751 274.74218.24
黄冈市合计5.3814.3918.90100.44155.46602.26151.5254.69249.161 178.19259．21
), ArticleFig(id=1241771815601766697, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771802712671057, language=EN, label=Table 2, caption=

Temporal and spatial scanning results of influenza inHuanggang City from 2014 to 2023

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年份聚集类别时间聚集地区
2014—2016年一类2015/6/14至2015/8/1黄州区
二类2016/11/13至2023/12/31罗田县
三类2016/3/20至2016/5/7黄梅县、武穴市
四类2015/6/21至2015/8/1红安县、麻城市
2017—2018年一类2017/12/19至2018/2/19黄州区
二类2017/12/19至2018/2/12罗田县
三类2017/8/1至2017/9/11蕲春县
四类2018/1/9至2018/2/26黄梅县、武穴市
五类2018/1/9至 2018/1/29红安县、团风县、麻城市
2019年一类2019/12/4至2019/12/31黄州区
二类2019/12/11至2019/12/31罗田县
三类2019/1/9至2019/3/12蕲春县
四类2019/12/18至2019/12/31黄梅县、武穴市
五类2019/12/11至2019/12/31红安县、麻城市
2020—2022年一类2022/6/11 至2022/8/12蕲春县、武穴市
二类2020/1/1至2020/1/24浠水县、黄州区
三类2022/7/2至 2022/11/18罗田县
四类2020/1/1至2020/1/24红安县、麻城市、团风县
2023年一类2023/3/6至 2023/4/9蕲春县、武穴市
二类2023/11/27至2023/12/31浠水县、黄州区
三类2023/11/20至2023/12/31罗田县、英山县、麻城市
坐标/半径病例数人口数RRLLRP值
(30.519031 N, 114.927670 E)/0 km216376 80038.51567.98<0.001
(30.929362 N, 115.468882 E)/0 km127549 40014.88221.25<0.001
(29.997273 N, 115.931088 E)/30.50 km1301 519 1005.48112.27<0.001
(31.288339 N, 114.618675 E)/44.46 km991 484 0004.9277.47<0.001
(30.519031 N, 114.927670 E)/0 km2 747376 80040.717 244.19<0.001
(30.929362 N, 115.468882 E)/0 km2 491549 40027.895 684.56<0.001
(30.325915 N, 115.590452 E)/0 km1 301776 60012.602 050.69<0.001
(29.997273 N, 115.931088 E)/30.50 km9741 519 1004.01603.20<0.001
(31.288339 N, 114.618675 E)/72.99 km5611 826 6004.39390.58<0.001
(30.519031 N, 114.927670 E)/0 km4 478376 80029.9410 616.77<0.001
(30.870817 N, 115.762804 E)/62.70 km3 8591 791 9007.014 049.91<0.001
(30.325915 N, 115.590452 E)/0 km3 515776 6004.842 642.06<0.001
(29.997273 N, 115.931088 E)/30.50 km1 7631 519 1005.371 499.81<0.001
(31.288339 N, 114.618675 E)/44.46 km1 8481 484 0003.831 091.45<0.001
(30.325915 N, 115.590452 E)/34.90 km4 6161 431 00015.758 009.81<0.001
(30.504749 N, 115.263464 E)/32.19 km2 0851 258 30019.224 110.01<0.001
(30.929362 N, 115.468882 E)/0 km2 539549 4009.303 294.03<0.001
(31.288339 N, 114.618675 E)/72.99 km7381 826 6004.44521.51<0.001
(30.325915 N, 115.590452 E)/34.90 km9 5981 431 0007.6310 590.37<0.001
(30.504749 N, 115.263464 E)/32.19 km8 3131 258 3007.378 997.54<0.001
(30.929362 N, 115.468882 E)/48.83 km7 8381 789 9003.984 683.00<0.001
), ArticleFig(id=1241771815765344567, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771802712671057, language=CN, label=表2, caption=

黄冈市2014—2023年流感时空扫描结果一览表

, figureFileSmall=null, figureFileBig=null, tableContent=
年份聚集类别时间聚集地区
2014—2016年一类2015/6/14至2015/8/1黄州区
二类2016/11/13至2023/12/31罗田县
三类2016/3/20至2016/5/7黄梅县、武穴市
四类2015/6/21至2015/8/1红安县、麻城市
2017—2018年一类2017/12/19至2018/2/19黄州区
二类2017/12/19至2018/2/12罗田县
三类2017/8/1至2017/9/11蕲春县
四类2018/1/9至2018/2/26黄梅县、武穴市
五类2018/1/9至 2018/1/29红安县、团风县、麻城市
2019年一类2019/12/4至2019/12/31黄州区
二类2019/12/11至2019/12/31罗田县
三类2019/1/9至2019/3/12蕲春县
四类2019/12/18至2019/12/31黄梅县、武穴市
五类2019/12/11至2019/12/31红安县、麻城市
2020—2022年一类2022/6/11 至2022/8/12蕲春县、武穴市
二类2020/1/1至2020/1/24浠水县、黄州区
三类2022/7/2至 2022/11/18罗田县
四类2020/1/1至2020/1/24红安县、麻城市、团风县
2023年一类2023/3/6至 2023/4/9蕲春县、武穴市
二类2023/11/27至2023/12/31浠水县、黄州区
三类2023/11/20至2023/12/31罗田县、英山县、麻城市
坐标/半径病例数人口数RRLLRP值
(30.519031 N, 114.927670 E)/0 km216376 80038.51567.98<0.001
(30.929362 N, 115.468882 E)/0 km127549 40014.88221.25<0.001
(29.997273 N, 115.931088 E)/30.50 km1301 519 1005.48112.27<0.001
(31.288339 N, 114.618675 E)/44.46 km991 484 0004.9277.47<0.001
(30.519031 N, 114.927670 E)/0 km2 747376 80040.717 244.19<0.001
(30.929362 N, 115.468882 E)/0 km2 491549 40027.895 684.56<0.001
(30.325915 N, 115.590452 E)/0 km1 301776 60012.602 050.69<0.001
(29.997273 N, 115.931088 E)/30.50 km9741 519 1004.01603.20<0.001
(31.288339 N, 114.618675 E)/72.99 km5611 826 6004.39390.58<0.001
(30.519031 N, 114.927670 E)/0 km4 478376 80029.9410 616.77<0.001
(30.870817 N, 115.762804 E)/62.70 km3 8591 791 9007.014 049.91<0.001
(30.325915 N, 115.590452 E)/0 km3 515776 6004.842 642.06<0.001
(29.997273 N, 115.931088 E)/30.50 km1 7631 519 1005.371 499.81<0.001
(31.288339 N, 114.618675 E)/44.46 km1 8481 484 0003.831 091.45<0.001
(30.325915 N, 115.590452 E)/34.90 km4 6161 431 00015.758 009.81<0.001
(30.504749 N, 115.263464 E)/32.19 km2 0851 258 30019.224 110.01<0.001
(30.929362 N, 115.468882 E)/0 km2 539549 4009.303 294.03<0.001
(31.288339 N, 114.618675 E)/72.99 km7381 826 6004.44521.51<0.001
(30.325915 N, 115.590452 E)/34.90 km9 5981 431 0007.6310 590.37<0.001
(30.504749 N, 115.263464 E)/32.19 km8 3131 258 3007.378 997.54<0.001
(30.929362 N, 115.468882 E)/48.83 km7 8381 789 9003.984 683.00<0.001
), ArticleFig(id=1241771816012808515, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771802712671057, language=EN, label=Table 3, caption=

Summary of ILI cases in Huanggang City from 2014 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
年份流感样病例各年龄段占比(%)流感样病例总数门急诊病例就诊总数ILI%值
0~5~15~25~60~
201441.5728.2110.3213.965.932 80047 9245.84%
201536.8830.6410.1917.754.543 54455 8926.34%
201632.0434.639.1119.015.222 39454 2884.41%
201730.8429.6510.3123.855.343 87861 5046.31%
201824.9225.6114.4527.677.364 07764 3796.33%
201921.5335.7815.9120.895.899 11093 8159.71%
202033.0220.8615.5525.085.495 61494 1815.96%
202147.0625.436.9816.853.6859 6141 012 8625.89%
202234.5923.648.4821.3911.91104 3831 921 2195.43%
202329.8931.309.7117.6611.44213 0391 617 10213.17%
合计33.5628.369.2718.819.99408 4535 023 1668.13%
), ArticleFig(id=1241771816188969295, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771802712671057, language=CN, label=表3, caption=

2014—2023年黄冈市ILI病例汇总表

, figureFileSmall=null, figureFileBig=null, tableContent=
年份流感样病例各年龄段占比(%)流感样病例总数门急诊病例就诊总数ILI%值
0~5~15~25~60~
201441.5728.2110.3213.965.932 80047 9245.84%
201536.8830.6410.1917.754.543 54455 8926.34%
201632.0434.639.1119.015.222 39454 2884.41%
201730.8429.6510.3123.855.343 87861 5046.31%
201824.9225.6114.4527.677.364 07764 3796.33%
201921.5335.7815.9120.895.899 11093 8159.71%
202033.0220.8615.5525.085.495 61494 1815.96%
202147.0625.436.9816.853.6859 6141 012 8625.89%
202234.5923.648.4821.3911.91104 3831 921 2195.43%
202329.8931.309.7117.6611.44213 0391 617 10213.17%
合计33.5628.369.2718.819.99408 4535 023 1668.13%
), ArticleFig(id=1241771816390295897, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771802712671057, language=EN, label=Table 4, caption=

Correlation test results of ILI% and positive rate of influenza virus

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年份2014年2015年2016年2017年2018年2019年2020年2021年2022年2023年
r0.230.080.080.350.680.730.230.120.190.83
P0.100.550.590.01<0.01<0.010.100.420.18<0.01
), ArticleFig(id=1241771816490959203, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771802712671057, language=CN, label=表4, caption=

ILI%与流感病毒阳性率相关性检验结果一览表

, figureFileSmall=null, figureFileBig=null, tableContent=
年份2014年2015年2016年2017年2018年2019年2020年2021年2022年2023年
r0.230.080.080.350.680.730.230.120.190.83
P0.100.550.590.01<0.01<0.010.100.420.18<0.01
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2014—2023年黄冈市流行性感冒流行病学特征及时空聚集性分析
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陈宇 1, 3 , 陈琦 2 , 吴杨 2 , 黄鑫胜 1 , 付进飞 1 , 易磊 1 , 王芬 1
现代预防医学 | 流行病与统计方法 2024,51(20): 3664-3671
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现代预防医学 | 流行病与统计方法 2024, 51(20): 3664-3671
2014—2023年黄冈市流行性感冒流行病学特征及时空聚集性分析
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陈宇1, 3, 陈琦2, 吴杨2, 黄鑫胜1, 付进飞1, 易磊1, 王芬1
作者信息
  • 1.黄冈市疾病预防控制中心，湖北 黄冈 438000
  • 2.湖北省疾病预防控制中心
  • 3.湖北省一线现场流行病学培训项目

    • 陈宇（1992—），女，本科，主治医师，研究方向：临床医学

通讯作者:

王芬，E-mail:
Epidemiological characteristics and spatiotemporal clustering of influenza, Huanggang, 2014-2023
Yu CHEN1, 3, Qi CHEN2, Yang WU2, Xin-sheng HUANG1, Jin-fei FU1, Lei YI1, Fen WANG1
Affiliations
  • Huanggang Municipal Center for Disease Control and Prevention, Huanggang, Hubei 438000
出版时间: 2024-10-25 doi: 10.20043/j.cnki.MPM.202406274
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摘要
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目的

分析2014—2023年黄冈市流行性感冒（influenza，简称流感）的流行情况，为黄冈市流感防控提供参考依据。

方法

收集2014—2023年黄冈市流感网报数据、ILI监测数据、病原学检测数据进行分析。

结果

2014—2023年黄冈市报告流感各年的发病率在5.38 /10万( 2014年) ~1 178.19/10万( 2023年)之间，变化趋势为先上升（2014—2019年）后下降（2020—2022年），2023年达峰值。回顾性时空扫描分析显示，发病时间主要集中在每年的12月及次年的1月、2月，在流行季节，黄州、罗田、蕲春、武穴是主要的一类和二类聚集区。2014—2023年黄冈市各年度ILI%值在4.41% ~13.17%之间，各个年度ILI%差异有统计学意义（χ2= 83 652.46，P<0.01），年度变化趋势与流感网报情况类似。ILI病例标本流感病毒阳性率整体上呈现冬春季高峰、夏季小高峰的特点，H3N2、H1N1、乙型BV型在各年度及年度内交替或共同流行。ILI%与流感病毒阳性率的相关性结果分析显示：除2014—2016、2020—2022年以外，其余4个年份显示两者正相关，P值均小于0.05，差异有统计学意义。

结论

黄冈市流感流行总体呈逐年上升趋势，发病有明显的季节特征及时空聚集性，以H1N1、H3N2、BV为主的优势毒株在年度内及不同年度间交替或共同流行。

流感监测  /  流感样病例  /  时空分析  /  病原学
Objective

The epidemic situation of influenza from 2014 to 2023 in Huanggang City was analyzed to provide reference for prevention and control of influenza in Huanggang City.

Methods

The data of influenza online report, ILI monitoring data and etiological detection data in Huanggang City from 2014 to 2023 were collected and analyzed.

Results

From 2014 to 2023, the annual incidence of influenza in Huanggang City ranged from 5.38/100,000 (2014) to 1,178.19/100,000 (2023), with a trend of first increasing (2014-2019), then decreasing (2020-2022), and reaching a peak in 2023.Retrospective spatiotemporal scanning analysis showed that the onset time was mainly concentrated in December of each year and January and February of the following year. In the epidemic season, Huangzhou, Luotian and Qichun were the main cluster areas of Class I and Class II. The ILI% value of each year in Huanggang City from 2014 to 2023 ranged from 4.41% to 13.17%, and the difference of ILI% each year was statistically significant (χ2=83 652.46,P<0.01), and the annual change trend was similar to that reported by influenza network.The positive rate of influenza virus in ILI case samples showed the characteristics of peak in winter and spring and small peak in summer, and H3N2, H1N1 and BBV were alternately or co-prevalent in each year and within each year.The analysis of correlation results between ILI% and positive rate of influenza virus showed that: except 2014-2016 and 2020-2022, the other 4 years showed positive correlation, and the P-value was less than 0.05,

Conclusion

The prevalence of influenza in Huanggang showed an increasing trend year by year, with obvious seasonal characteristics and temporal and spatial aggregation. The dominant strains, mainly H1N1, H3N2 and BV, alternated or co-circulated within the year and between different years.

Influenza surveillance  /  Influenza-like cases  /  Spatiotemporal analysis  /  Etiology
陈宇, 陈琦, 吴杨, 黄鑫胜, 付进飞, 易磊, 王芬. 2014—2023年黄冈市流行性感冒流行病学特征及时空聚集性分析. 现代预防医学, 2024 , 51 (20) : 3664 -3671 . DOI: 10.20043/j.cnki.MPM.202406274
Yu CHEN, Qi CHEN, Yang WU, Xin-sheng HUANG, Jin-fei FU, Lei YI, Fen WANG. Epidemiological characteristics and spatiotemporal clustering of influenza, Huanggang, 2014-2023[J]. Modern Preventive Medicine, 2024 , 51 (20) : 3664 -3671 . DOI: 10.20043/j.cnki.MPM.202406274
正文
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流感是由流感病毒引起的一种急性呼吸道传染病，严重危害人群健康。流感病毒其抗原性易变，传播迅速，每年可引起季节性流行，在学校、托幼机构和养老院等人群聚集的场所易发生暴发疫情[1]。从2009年开始，黄冈市建立了国家级流感监测哨点医院和网络实验室，2020年开始黄冈市的各县市区逐步建立了省级流感监测哨点医院和网络实验室，通过长期持续监测，黄冈市在2015年发现了湖北省的首例人感染H7N9禽流感病例[2]，2021年通过流感样病例的监测采样，发现2例H9N2亚型病例，说明通过现有的流感监测网络，可以及时发现流感变异株，快速处置疫情，防止流感疫情暴发。本文通过对黄冈市2014—2023年10年间流感病例流行特点及时空聚集性进行分析，为流感精准防控提供科学依据。
1　材料与方法
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1.1　数据来源
监测数据来自“中国疾病预防控制信息系统”业务子系统 “传染病监测系统”和“中国流感监测信息系统”。人口数据来自“人口普查数据”。
1.2　相关定义
（1）流感样病例（ILI）[3-5]即发热（体温≥38℃），伴咳嗽或咽痛之一的病例，同时缺乏其他实验室诊断依据。（2）ILI 百分比（简称ILI%）：ILI/门急诊病例就诊总数×100%，该指标用于反映流感流行强度。（3）ILI监测年度：以当年14周至下一年第13周为一个监测年度[4-5]。（4）ILI监测季度：10~22周为春季，23~35周为夏季，36~48周为秋季，49~次年9周为冬季[4-5]。
1.3　统计学处理
采用Excel 2016建立数据库，使用SPSS 19.0软件进行统计学分析，率和构成比的比较采用χ2检验。运用SatScan 9.4.1软件进行时空扫描分析，将模型最大空间扫描区域设定为全区总人口数的30%，扫描时间以日为单位，县（市、区）为空间扫描单位，时空分析选择Poisson分布模型 [6-7]。检验水准α=0.05。
2　结果
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2.1　流感网报监测结果
2.1.1　基本情况
2014—2023年黄冈市累计报告流行性感冒152 483例，年均发病率为247.00/10万，累计死亡病例3例（2020年、2021年、2023年各1例）。各年发病率在5.38 /10万（ 2014年） ~1 178.19 /10万（ 2023年）之间，年度间发病率有统计学差异（χ2=296 968.92，P<0.01），2014—2019流感总体呈上升趋势（χ2=111 156.82，P<0.01），2019—2022流感总体呈下降趋势（χ2=39 694.58，P<0.01），2023年达峰值（1 178.19/10万）。见图1。
2.1.2　时间分布
2014—2016年流感发病数较低，在1 200例/年以下，2014年峰值不明显，2015年、2017年、2022年高峰出现在6—8月份，其中2022年还有一个11月份的小高峰；2016年峰值出现在4月、11月，2018年高峰出现在1—3月；2019年全年发病数整体较高，12月为最高峰，1—6月为小高峰；2020年仅1月为高峰；2021年仅12月为高峰；2023年双高峰，分别是2—4月，11—12月，具体见下图2。黄冈市流感发病总体呈现是冬春季高峰为主，或伴有夏季小高峰，2016年和2018年没有夏季高峰，紧随其后的2017年和2019年出现流感发病数明显上升，且伴双峰。
2.1.3　地区分布
黄冈市各县市区发病率在时间上均呈逐年上升趋势，2020—2022年特殊；2019年和2023年，分别均达到了近6年、10年的峰值，其中年均发病率前五位依次是黄州（526.72/10万），蕲春（436.89/10万），罗田（416.64/10万），武穴（218.24/10万），浠水（213.89/10万），以上5地多个年份发病率居于全市前位，明显高于其它县市区。
2.1.4　人群分布
男女性别比为1.32:1，男性发病率高于女性（χ2=1 710.09，P<0.01），按5岁年龄段分为17组，发病主要集中在0~<5和5~<10岁年龄组（岁）儿童，分别占比34.70%、31.17%，见图3。2014—2017年，人群占比居于前三位的是散居儿童、农民、学生，总占比在72%~84%；2018—2023年，人群占比居于前三位的是学生、散居儿童、幼托儿童，总占比达79%~92%，见图4。
2.1.5　回顾性时空扫描分析（以县区为尺度）
对黄冈市2014—2023年流感网报发病数进行回顾性时空扫描分析，在各年份分别探测到以下时空聚集区域，见表2。从时间分布上来看，发病聚集时间主要集中在每年的12月及次年的1月、2月，少数年份出现6~8月的聚集；从地区分布上来看，2014—2019年，一类聚集区主要为黄州区，二类聚集区主要为罗田县，2020—2023年，一类聚集区主要为蕲春县和武穴市，二类聚集区主要为黄州区和浠水。
2.2　ILI监测结果
2.2.1　基本情况
2014—2023年黄冈市流感监测哨点医院监测诊室总有5 023 166例病例就诊，其中ILI有408 453例，总ILI%为8.13%，各个年度ILI%值在4.41%~13.17 %之间，各年度间ILI%值差异存在统计学意义（χ2=83 652.46，P<0.01）。2014—2019年ILI%总体呈上升趋势（趋势χ2=1 869.14，P<0.01），2019—2022年总体呈下降趋势（χ2=3 122.76，P<0.01），2023年ILI百分比达最高值13.17%。见表3。
2.2.2　时间分布
以ILI%连续4周超过9.5%为一个流行高峰，结果显示2014年出现一个秋季高峰，2015、2020年为夏季高峰，2016年高峰不明显，2017—2019年为冬季高峰，2021年春夏季高峰，2022年第50周至第52周连续3周ILI%在9.54%~16.40%，接着就是第9周延迟开始的冬季高峰，2023年特殊，全年都在一个比较高的水平，且峰值较高，接近30%。2019年的第50周至2020年第10周，ILI%异常增高，最高值近50%。ILI总体呈现冬春季高峰，或伴夏秋季小高峰特点。见图5。
2.2.3　ILI百分比与流感病毒阳性率相关性比较[8-9]
2014—2023年ILI%与流感病毒阳性率的Spearman秩相关分析结果显示：以年度为单位，两者相关系数r为0.45，P值为0.22，无明显统计学意义；但年度内相关性比较显示，除2014—2016、2020—2022年以外，其余4个年份显示两者正相关，P值均小于0.05，差异有统计学意义。具体结果见下表4。
2.3　病原学监测结果
2014—2024年5月10日黄冈市共采集流感样病例标本31 455份，阳性数5 282份，阳性率16.79%，其中H3N2 2 469份（占比46.74%），H1N1 1 149份（占比21.75%），BV 1 412份（占比26.73%），BY 112份（占比2.12%）。近10年的流感病原监测中，仅2个监测年份（2020年、2021年）以乙型BV为主，其余年份均是甲型构成比为主，另外，2023年度冬春季先是以H3N2为主，后逐渐转变为BV为主。流感病毒阳性率整体上呈现冬春季高峰、夏季小高峰的特点，病原学分型表现为：甲型中以H3N2和H1N1为主，乙型中以BV型为主，各年度及年度内各种型别交替或共同流行。见图6。
3　讨论
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2014—2023年黄冈市流感网报发病率和ILI%在各个年度间差异有统计学意义，2014—2019年总体呈上升趋势，2020—2022年有所下降，2023年均达峰值，这与2011—2019全国[6]、2017—2019江西省[7]、2016—2022成都市[10]情况一致。分析2019年达到较高值的原因可能有：据“免疫规划信息管理系统”中数据显示，2019年黄冈市流感疫苗接种数为近10年最低，群体流感免疫水平降低。2020—2022年ILI%较前下降，与北京市[11-12]、成都市[13]的监测情况类似，可能与这三年人群流动性降低，以及戴口罩、勤洗手、多通风等防范意识增强有关。2022年年末及2023年流感发病率及ILI%大幅上升，与成都市[10]情况类似，这可能与2022年冬末新冠疫情管控措施放开，人群流动性、聚集性增加，以及前两年极低的流感发病水平而导致的免疫补偿有关。
时间分布上看，黄冈市流感发病具有明显的季节性，从流感网报数的时间分布、ILI%时间分布以及流感网报数回顾性时空扫描分析结果上看，三者的一致性较好，均提示每年的冬春季是主要的发病高峰，或伴有夏秋季小高峰。
从时空聚集性看，2014—2023年黄冈市在流行季节，病例在地区上呈现明显的时空聚集性，黄州区、罗田县、蕲春县、武穴是发病较高的风险聚集区。分析可能与人口密度[14]、地理环境、经济发展等因素有关[6]。研究中发现相对较短时间内以回顾性时空重排扫描方法更适用于黄冈市流感时空聚集性探测，以日为时间单位比以月和年为时间单位探测的聚集时间点更精确，这与江西省研究结果一致[7]，且在不同年份发病数相差较大时，分年份探测聚集区域及时间更精确更稳定,提示回顾性时空重排扫描方法多用于对于历史数据的时空聚集性探测，且需要在不同参数设定下选择最优参数。
从病原学分型上看，2014年—2023年ILI%及流感病毒阳性率总体呈现冬春季高峰、夏季小高峰的特点，这与2016—2019年湖北省[15-17]、鄂州[18]、湖南[19]、安徽[20]的情况一致，但2020年及2021年ILI%高峰不明显，且2020年全年ILI病例只检测到1份阳性标本（BV型），2021年流感病毒检测也是以BV型为主（占比98.30%），这与北京大兴区[11]、成都[13]、鄂州市[18]、广西[21]、贵州[22]情况一致。分析其原因可能与2020年、2021年各地限制人员流动以及戴口罩、勤洗手的宣传措施有关，2023—2024年的冬春季由H3N2为主向以BV型为主的转变特征，与中国疾病预防控制官网上中国流感模块公布的南方省份流感病原学情况基本一致。
ILI%与流感病毒阳性率的相关性结果分析显示：除2014—2016、2020—2022年以外，其余4个年份均显示两者正相关，2014—2016年ILI%与流感病毒阳性率的相关性无统计学意义，分析其可能原因是这三个年份报告的病例数较少，且仅只有一个哨点医院，监测的标本太少，数据质量不高；2020—2022年两者相关性不高，分析其原因是新冠病毒感染症状与流感样病例类似，故ILI%也会随着新冠病毒感染者的波动出现变化，加之防控措施的影响；但是，流感网报数高峰、ILI%高峰、流感病毒阳性率高峰总体上重合性比较好，另外本市ILI%及其病原学监测与湖北省及相邻的鄂州市情况类似，综上，本市ILI的整体监测质量较好。同时ILI监测的意义重大，一方面，从既往10年的监测结果来看，可以发现“群防群控、多病同防、限制人员流动、戴口罩”等预防措施在一定程度上降低了流感等呼吸道传染病的发病率；另一方面，由于多种传染病的症状表现上都与流感样病例类似，通过ILI%及病原学监测，可以及时发现流感等传染病的上升趋势，发现流感变异株等病原体，同时结合时空模型分析，通过回顾性分析找出流感可能暴发疫情的聚集性区域，为本地区流感大流行的早期预警，现场调查干预，提供了科学依据，从而将流感等传染病的危害降到最低。
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2024年第51卷第20期
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doi: 10.20043/j.cnki.MPM.202406274
  • 接收时间：2024-06-18
  • 首发时间：2026-03-20
  • 出版时间：2024-10-25
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  • 收稿日期：2024-06-18
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湖北省公共卫生青年拔尖人才项目
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    1.黄冈市疾病预防控制中心，湖北 黄冈 438000
    2.湖北省疾病预防控制中心
    3.湖北省一线现场流行病学培训项目

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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
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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