Kristufkova Z, Blaskovicova H
National Center of Influenza, State Health Institute of Slovak Republic, Bratislava, Slovakia.
Bratisl Lek Listy. 2000;101(11):603-10.
Acute respiratory infections (ARI) represent the most frequent cause of morbidity. Their epidemic outbreaks become a severe problem not only in healthcare, but also in economical and social spheres.
Presentation of epidemiological and virologic characteristics of the 1999-2000 influenza season in Slovakia; their comparison with the same Influenza season in other European countries, as well as with the situation during the preceding season in Slovakia.
The epidemiological analysis of Influenza and influenza-like diseases is based on the duty of attending physicians to report the number of new cases, complications, cases of working inability due to disease, and death cases. The reports are required on a compulsory weekly basis, and the reported cases are structured into 4 age groups. The laboratory diagnosis is based on virus isolation, rapid detection of antigen and serological tests.
The outbreak of Influenza spread through Slovakia during the period between the 4th and 8th calendar weeks with its peak appearing during the 6th calendar week, when its incidence reached 2821 cases/100,000. The age group mostly afflicted by morbidity during the entire investigated season were children at the age of 0-5, while during the outbreak, the highest morbidity was reported among school children at the age of 6-14. The epidemic broke out on the entire territory of the Slovak Republic at the same time. 5 death cases were reported. Complicated cases were reported in 6.1% of the diseased. 34.1% of the group at the age from 15 to 59 were reported to be unable to work due to disease. 25 isolates of influenza virus were obtained from 505 nasopharyngeal swabs. 2 strains were found to be atigenetically similar to the vaccine strain A(H3N2)/Sydney 5/97 and A(H3N2)/Moscow 10/99. Regarding ARI aetiology, influenza viruses were serologically confirmed in 1356 samples; out of which type A(H3N2) was confirmed in 930 cases, A(H1N1) in 143 cases, type B in 283 cases; adenoviruses were detected in 467 samples; RS viruses in 779 samples; and Mycoplasma pneumoniae in 859 samples. Mixed infection caused by two viruses was diagnosed in 27 cases.
The outbreak which hit Slovakia in the 1999/2000 season was a part of the European epidemic wave. As to its extent, it was a mild epidemic outbreak. It was significantly low as to its incidence among children. During autumn months, ARI aetiology was dominated by M. pneumoniae, viruses of type A(H3N2) prevailed.
The identification of strains isolated during the investigated season confirmed that strains of influenza virus similar to strain A(H3N2)/Sydney 5/97 which is contained within the vaccine which has been assessed for this season, circulated in Slovakia during the past two subsequent seasons. Similar experience was reported from the majority of European countries involved in the international WHO programme of influenza Surveillance. These facts explain the mild extent of the investigated epidemic outbreak. (Tab. 5, Fig. 7, Ref. 8.)
急性呼吸道感染(ARI)是发病率最高的病因。其疫情爆发不仅在医疗保健领域,而且在经济和社会领域都成为一个严重问题。
介绍斯洛伐克1999 - 2000年流感季节的流行病学和病毒学特征;将其与其他欧洲国家同一流感季节以及斯洛伐克上一季节的情况进行比较。
流感及流感样疾病的流行病学分析基于主治医师报告新病例数、并发症、因病无法工作的病例数和死亡病例数的职责。报告要求每周强制进行,报告的病例分为4个年龄组。实验室诊断基于病毒分离、抗原快速检测和血清学检测。
流感疫情在第4至第8个日历周期间蔓延至斯洛伐克,在第6个日历周达到高峰,发病率达到2821例/10万。在整个调查季节中发病最多的年龄组是0 - 5岁的儿童,而在疫情爆发期间,发病率最高的是6 - 14岁的学童。疫情同时在斯洛伐克共和国全境爆发。报告了5例死亡病例。6.1%的患病者出现并发症。15至59岁年龄组中有34.1%的人因病无法工作。从505份鼻咽拭子中获得了25株流感病毒分离株。发现2株病毒在抗原上与疫苗株A(H3N2)/悉尼5/97和A(H3N2)/莫斯科10/99相似。关于ARI病因,在1356份样本中通过血清学确诊了流感病毒;其中A(H3N2)型在930例中得到确诊,A(H1N1)型在143例中得到确诊,B型在283例中得到确诊;在467份样本中检测到腺病毒;在779份样本中检测到呼吸道合胞病毒;在859份样本中检测到肺炎支原体。27例诊断为两种病毒引起的混合感染。
1999/2000年袭击斯洛伐克的疫情是欧洲疫情波的一部分。就其规模而言,是一次轻度疫情爆发。其在儿童中的发病率显著较低。在秋季月份,ARI病因以肺炎支原体为主,A(H3N2)型病毒占主导。
对调查季节分离出的毒株进行鉴定证实,与本季节评估的疫苗中所含的A(H3N2)/悉尼5/97毒株相似的流感病毒毒株在斯洛伐克过去两个后续季节中传播。参与世界卫生组织国际流感监测计划的大多数欧洲国家也报告了类似情况。这些事实解释了所调查疫情爆发的轻度程度。(表五,图七,参考文献8)