目的 对安徽省发生的首起家庭聚集性人感染H7N9禽流感疫情进行现场调查分析,探讨感染来源和传播方式,为今后H7N9禽流感防控与疫情处置工作提供参考。方法 应用现场流行病学方法对2例患者的发病就诊经过、可疑暴露史、流行病学关联及密切接触者进行调查;采集病人及相关活禽市场标本,开展流感病毒核酸检测。结果 本次家庭聚集性疫情共发病2人,为母子关系;首发病例2月4日发病,发病前有明确的活禽市场暴露史;续发病例2月15日发病,发病前既有活禽市场暴露史,也有与首发病例的密切接触史;共采集相关环境标本38份,其中13份标本检出H7阳性,均来自当地自活禽市场。结论 首发病例的感染来源可能为活禽市场暴露,续发病例的感染来源既可能是活禽市场暴露,也可能为人-人传播;在H7N9疫情调查处置中,应做好密接管理和个人防护工作。

Objective To understand the source of infection and dissemination of the way through the field investigation and analysis on the first family clustering avian influenza A(H7N9), in order to provide reference for avian influenza A(H7N9) prevention and control in the future. Methods Field epidemiology was conducted to investigatethe process of incidence and treatment, the history of suspected exposure, and epidemiological associationand close contact persons of 2 patients. Specimens from patients and live poultry markets were collected to carry out the nucleic acid detection of influenza virus. Results This family clustering avian influenza A(H7N9) included 2 patients as mother child relationship. First case was onset on February 4, and she had a clear live poultry market exposure history before onset. Secondary case was onset on February 15, and he had both the history of live bird markets exposure, and the close contact history with first case before onset. A total of 38 specimens were collected and tested, 13 of them were detected H7N9 positive, which all came from the live poultry markets. Conclusion Live poultry markets exposure may be the source of infection of the first case. The infection sources of the secondary case both may be exposed to the live poultry markets and a human to human transmission from the first case. In H7N9 epidemic investigation and disposal, the management of close contact persons and personal protection work should be well done.