Objective To investigate the distribution of avian influenza virus in the poultry related environment and the infection of avian influenza virus in population with occupational exposure to avian influenza virus,and provide evidence for the prevention and control of human avian influenza in this area.Methods The poultry related environment samples,the respiratory tract samples of pigs and the serum of population with occupational exposure to poultry and pigs were collected. Real time fluorescence quantitative PCR was used to detect the nucleic acid of influenza A virus in the poultry related environment samples and the respiratory tract samples of pigs. The positive samples were tested for nucleic of subtype H5,H7,H9,N1,N2,N6 and N9. The antibodies to influenza A（H5N6）,（H7N9）and（H9N2）viruses in the serum of population with occupational exposure were detected by erythrocyte agglutination inhibition test（HI）. Results Avian influenza surveillance in poultry-related external environment,a total of 1 196 samples were collected from2019 to 2021,and the positive rates of Flu A,H5,H9,N1,N2 and N6 were 12.29%（147/1 196）,2.17%（18/1 196）,11.62%（139/1 196）,0.33%（4/1 196）,11.79%（141/1 196）and 3.26%（39/1 196）,H7 and N9 subtypes were not detected. Two or more HA or NA subtypes of AIV were detected simultaneously in 35cases,with a positive rate of 2.93%（35/1 196）. There were significant differences in the positive rate of AIV in different years,monitoring sites and sample types（χ~2=118.28,163.74,285.74,P＜0.05）. AIV has the highest positive detection rate in 2021,reaching 30.63%（83/271）;among the four types of surveillance sites,AIV is highly prevalent in urban and rural live poultry markets,with a detection rate of 24.95%（126/505）.Among the six types of samples,the AIV positive rate of other types of environmental samples,wiped specimens on the cutting board surface of slaughtered or placed poultry meat,and sewage from washing poultry exceeded 50%. No AIV positive was detected in 180 samples of porcine respiratory tract. 553 samples of serum samples from occupationally exposed groups such as poultry and pigs were monitored,and no H5,H7,H9 avian influenza antibodies were detected. Conclusion The positive rate of avian influenza virus in poultry related environment in Yangzhou is high,the AIV types are diverse,the genetic recombination is prone to occur,and the risk of infecting people is high. Therefore,comprehensive prevention and control measures should be actively taken to reduce the positive detection rate of avian influenza in the external environment of the region and reduce human infection risk.

Between August and September, 2021, this study included 605 SARS-CoV-2 natural infection cases and 589 SARS-CoV-2 breakthrough cases from Nanjing and Yangzhou, as well as 690 inactivated COVID-19 vaccine recipients from Changzhou, China. In SARS-CoV-2 natural infection cases, the age range was 19-91 years (median age: 66 year), and the medians(Q1,Q3) of IgG titers were 0.19 (0.06-1.31), 3.70 (0.76-69.48), 15.31 (2.59-82.16), 4.41 (0.99-31.74), 2.31 (0.75-13.83), 2.28 (0.68-9.94) and 2.80 (1.00-9.53) at one to seven weeks after SARS-CoV-2 infection, respectively. In SARS-CoV-2 breakthrough cases, the age range was 18-76 years (median age: 45 year), and the medians(Q1,Q3)of IgG titers were 1.93 (0.34-26.67), 38.87 (7.90-121.0), 75.09 (11.85-123.70), 21.97 (5.20-95.58), 13.97 (3.47-46.82), 9.56 (2.48-33.38) and 4.38 (1.87-11.00) at one to seven weeks after SARS-CoV-2 infection, respectively. In inactivated COVID-19 vaccine recipients, the age range was 18-87 years (median age: 47 years), and the medians(Q1,Q3)of IgG titers were 16.22 (15.84-33.42), 5.35 (2.96-13.23), 3.30 (2.18-6.18), 3.14 (1.16-5.70), 2.77 (1.50-4.52), 2.72 (1.76-4.36), 2.01 (1.27-3.51) and 1.94 (1.35-3.09) at one to eight months after SARS-CoV-2 infection, respectively. The results suggested that IgG antibodies increased gradually within two weeks after SARS-CoV-2 infection, then declined gradually at three to seven weeks in SARS-CoV-2 natural infection cases. In SARS-CoV-2 breakthrough cases, IgG antibodies increased rapidly within two weeks, then declined gradually at three to seven weeks after SARS-CoV-2 infection. Additionally, IgG antibodies decreased rapidly within three months, then decreased gradually and remained at a low level within three months after immunization.

目的 掌握扬州市2020年报告的新型冠状病毒肺炎(新冠肺炎)确诊病例的临床特征,为科学防控提供依据.方法 对确诊病例进行回顾性流行病学调查,收集临床相关资料,对病例病程早期和中后期的临床症状进行比较,并对有无肺炎影像学改变的病例相关特征进行分析.结果 共报告23例确诊病例,临床症状以咳嗽(91.3％)、发热(87.0％)为主,病程中最高温38.1℃～39℃的中热10例,占43.5％;37.3℃～38.0℃的低热8例,占34.8％.病程早期(发病0～3天)60.9％有干咳症状,中后期(4天及以后)降低至21.7％;病程早期21.7％有咳痰,中后期增至52.2％;病程早期34.8％有乏力症状,中后期降至4.3％;以上差异均有统计学意义(P值均＜0.05).有明显肺炎影像学改变的13例(占56.5％),无明显改变的10例(占43.5％),有肺炎影像学改变病例的中高热比例为30.8％,而无影像学改变病例38℃以上中高热比例为80.0％,差异有统计学意义(P=0.036).结论 随着病程进展,新冠肺炎病例的咳嗽会由干咳为主转为以咳痰为主,乏力现象逐渐消失,近一半的病例有低热或不发热的现象,在疾病早期易造成漏诊或错过最佳诊疗时机,应引起重视.

目的 探讨新型冠状病毒肺炎(简称“新冠肺炎”)患者早期血生化指标改变,以及不同年龄、临床分型之间的差异.方法 收集扬州市2020年1-2月报告的23例新型冠状病毒肺炎患者的一般资料和治疗早期谷丙转氨酶、谷草转氨酶、乳酸脱氢酶和肌酸激酶等肝功能相关指标,并进行统计分析.结果 23例新冠肺炎患者中,男性10例(43.48％),女性13例(56.52％);平均年龄(49.65±13.08)岁,＜60岁18例,≥60岁5例;普通型肺炎12例(52.17％),轻型10例(43.48％),重型1例(4.35％).早期检测血生化指标显示:在收集的6项有关肝功能指标中,有9例患者出现异常,占39.13％.其中4例(17.39％)谷草转氨酶升高,3例(13.04％)谷丙转氨酶升高,6例(26.09％)乳酸脱氢酶升高,2例(8.70％)肌酸激酶升高,8例(34.78％)α-羟丁酸升高,1例(4.35％)碱性磷酸酶升高,2例(8.70％)谷氨酰转肽酶升高.≥60岁患者血清α-羟丁酸(F=5.099,P=0.035)、碱性磷酸酶(F=7.862,P=0.011)和谷氨酰转肽酶(F=7.184,P=0.014)的水平高于＜60岁患者.结论 部分新冠肺炎患者肝功能指标出现异常,≥60岁患者血清α-羟丁酸、碱性磷酸酶和谷氨酰转肽酶水平高于＜60岁患者.

目的 了解扬州市新型冠状病毒肺炎(简称“新冠肺炎”)病例的密切接触者流行病学特征,为密切接触者的精准管控提供依据.方法 采用描述性流行病学方法分析病例密切接触者特征,并采集咽拭子标本进行核酸检测.结果 纳入研究新型冠状病毒肺炎病例密切接触者725人.男女比为0.92:1,平均年龄(43.57±18.62)岁.检出核酸检测阳性标本20份,阳性率2.76％.与病例不同关系、接触频率、地点、方式等人群阳性率差异均有统计学意义(P值均＜0.05),不同性别、年龄、暴露时间人群阳性率差异均无统计学意义(P值均＞0.05).多因素logistic回归分析结果显示,接触地点为家中是密切接触者咽拭子核酸检测阳性的危险因素(OR=8.578,95％ CI:1.607～45.789,P=0.012).结论 及时发现新型冠状病毒肺炎病例,及时实施隔离,并加强其密切接触者管理,对疫情防控具有重要意义.

目的 了解江苏省扬州市2020年1月23日-2月16日报告的新型冠状病毒肺炎(COVID-19)流行特征,为提高COVID-19疫情防控能力提供依据.方法 以2020年1月23日-2月16日扬州市报告的23例COVID-19确诊病例为研究对象,根据《新型冠状病毒肺炎防控方案(第五版)》开展现场流行病学调查,收集病例性别、年龄、职业、首次发病临床症状和流行病学史等信息,排查密切接触者,检测严重急性呼吸道综合征冠状病毒2型(SARS-CoV-2)核酸,分析病例的临床表现、三间分布和暴露史等流行特征.结果 扬州市报告的23例COVID-19确诊病例中,临床分型为普通型12例,占52.17％;轻型10例,占43.48％;重型1例.首发症状以发热为主,17例占73.91％;所有病例胸部CT均显示肺部有磨玻璃影.男性10例,女性13例,男女比为0.77∶1,40～59岁14例,占60.87％;职业以工人和离退休人员为主,各4例占17.39％.病例发病高峰为1月23日-29日,分布在江都区、宝应县、邗江区和广陵区4个地区.发病前14 d有武汉市旅居史14例,有本地COVID-19确诊病例接触史6例,有武汉市归来人员接触史2例,有太原市旅居史1例.2例病例肛拭子检出SARS-CoV-2核酸阳性.结论 扬州市23例COVID-19确诊病例症状较轻,首发症状以发热为主,均存在肺部影像学改变;病例年龄集中在40岁及以上,多数为输入病例.

目的 了解扬州市流感流行病学特征,为疫情防控提供科学依据.方法 收集2010-2013年扬州市3家流感监测哨点医院的流感相关资料,结合实验室病原学监测资料,采用卡方检验、线性相关等方法进行分析描述流感流行病学特征.结果 用流感样病例(ILI)占门急诊就诊人数百分比(ILI％)×流感核酸检测阳性率作为流感活动强度的指标,扬州市流感疫情存在明显规律,每年有2个高峰和1个低谷;婴幼儿所占比例最高,＞25岁成人组和＞60岁老年组所占比例呈现总体下降趋势;城区和县区的ILI就诊情况基本保持一致(r=0.79),但城区的ILI％高于县区;近4年本市流感流行毒株呈现一定规律的周期性变化,一般经历非流行株到与流行株混合存在,再到取代前者成为新的流行株的一个变化过程.结论 传统的ILI发病数或ILI％并不能真实地反映流感流行现状,会受很多混杂因素的影响.ILI％×流感核酸检测阳性率作为流感活动强度指标,能客观、合理反映流感的动态变化.

目的 了解扬州市居民流行性感冒(流感)知识知晓情况及影响因素,为开展健康教育和健康干预提供依据.方法 采用多阶段随机抽样法,从社区居民、医院就诊患者和网民中选取478名调查对象,利用自行设计的问卷进行调查.结果 有效调查443人,流感知识知晓率为53.3％,其中“流感是否需要预防”知晓率较高(79.2％),“流感可通过呼吸道和密切接触传播”较低(15.1％),不同问题知晓率差异有统计学意义(P＜0.05).9个问题答对2/3为合格,合格率为49.4％,多因素logistic回归分析显示,网民、年龄20～ 45岁、无慢性病人群合格率较高(P值均＜0.05).结论 扬州市居民流感知识知晓率偏低,应加大健康教育力度.

当前,人感染H7N9禽流感发生、发展规律与流行特征受到人们广泛关注.本文通过溯时调查分析,追踪人感染H7N9禽流感病毒在扬州地区的发生发展时间,并借鉴各地监测资料研究人感染H7N9禽流感病毒传播扩散的流行病学.通过溯时调查初步分析,在扬州市及江苏区域内H7N9禽流感病毒在禽类感染可能出现在2、3月.研究结果为寻找扼制疫情的措施提供有力的证据.

Objective To discuss the epidemic characteristics and control measures of viral hepatitis E in Yangzhou.Method Do epidemiological analysis on the epidemic data of viral hepatitis E from 2004 to 2011.Results The incidence of hepatitis E showed an ascendant trend,and its morbidity had exceeded that of viral hepatitis A.The incidence of hepatitis E was high among people between 35 and 70 years old.Conclusions We should develop corresponding control work according to the epidemic feature of hepatitis E,and the control work and awareness should be improved.

目的:分析痢疾的流行病学特征及诊断分类,为掌握痢疾疫情的发生和发展趋势提供依据,并提出痢疾诊断标准修改的建议。方法:根据中国传染病疫情信息网络报告病例和扬州市2008-2010年疫情数据,采用Excel数据库绘制流行病学曲线,并对各年龄组实验室诊断率差异进行统计分析。结果:2008-2010年扬州市痢疾发病数总体呈逐年下降趋势,每年的夏秋季节为痢疾发病高峰;高邮地区痢疾发病率明显高于周边其他县(市、区),达27.91/10万,宝应县最低,为1.02/10万;婴幼儿组罹患率高,<1岁组占14.8%,1～3岁组占20.87%。结论:2008-2010年,扬州市痢疾病例婴幼儿组罹患率高,地区分布不均匀,主要是痢疾实验室诊断标准定义范围过宽所致。除加强痢疾防治知识的卫生宣传和对婴幼儿看护人的健康教育外,建议修订痢疾诊断标准。