2005年印度尼西亚的三起H5N1病毒感染群聚事件。

Three Indonesian clusters of H5N1 virus infection in 2005.

作者信息

Kandun I Nyoman, Wibisono Hariadi, Sedyaningsih Endang R, Hadisoedarsuno Widarso, Purba Wilfried, Santoso Hari, Septiawati Chita, Tresnaningsih Erna, Heriyanto Bambang, Yuwono Djoko, Harun Syahrial, Soeroso Santoso, Giriputra Sardikin, Blair Patrick J, Jeremijenko Andrew, Kosasih Herman, Putnam Shannon D, Samaan Gina, Silitonga Marlinggom, Chan K H, Poon Leo L M, Lim Wilina, Klimov Alexander, Lindstrom Stephen, Guan Yi, Donis Ruben, Katz Jacqueline, Cox Nancy, Peiris Malik, Uyeki Timothy M

机构信息

Directorate General of Disease Control and Environmental Health, Ministry of Health, Jakarta, Indonesia.

出版信息

N Engl J Med. 2006 Nov 23;355(21):2186-94. doi: 10.1056/NEJMoa060930.

DOI:10.1056/NEJMoa060930

PMID:17124016

Abstract

BACKGROUND

Since 2003, the widespread ongoing epizootic of avian influenza A (H5N1) among poultry and birds has resulted in human H5N1 cases in 10 countries. The first case of H5N1 virus infection in Indonesia was identified in July 2005.

METHODS

We investigated three clusters of Indonesian cases with at least two ill persons hospitalized with laboratory evidence of H5N1 virus infection from June through October 2005. Epidemiologic, clinical, and virologic data on these patients were collected and analyzed.

RESULTS

Severe disease occurred among all three clusters, including deaths in two clusters. Mild illness in children was documented in two clusters. The median age of the eight patients was 8.5 years (range, 1 to 38). Four patients required mechanical ventilation, and four of the eight patients (50%) died. In each cluster, patients with H5N1 virus infection were members of the same family, and most lived in the same home. In two clusters, the source of H5N1 virus infection in the index patient was not determined. Virus isolates were available for one patient in each of two clusters, and molecular sequence analyses determined that the isolates were clade 2 H5N1 viruses of avian origin.

CONCLUSIONS

In 2005 in Indonesia, clusters of human infection with clade 2 H5N1 viruses included mild, severe, and fatal cases among family members.

摘要

背景

自2003年以来，甲型禽流感（H5N1）在家禽和鸟类中广泛持续流行，已在10个国家导致人类感染H5N1病例。印度尼西亚的首例H5N1病毒感染病例于2005年7月被确认。

方法

我们调查了2005年6月至10月期间印度尼西亚的三起病例群，其中至少有两名患者因H5N1病毒感染的实验室证据而住院。收集并分析了这些患者的流行病学、临床和病毒学数据。

结果

所有三个病例群中均出现了严重疾病，其中两个病例群出现了死亡病例。两个病例群中有儿童出现轻症。八名患者的中位年龄为8.5岁（范围为1至38岁）。四名患者需要机械通气，八名患者中有四名（50%）死亡。在每个病例群中，感染H5N1病毒的患者均为同一家族成员，且大多数居住在同一家庭。在两个病例群中，首例患者的H5N1病毒感染源未确定。两个病例群中各有一名患者可获得病毒分离株，分子序列分析确定这些分离株为禽源2型H5N1病毒。