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[古巴甲型H1N1流感大流行第一波期间甲型H1N1流感病毒及其他呼吸道病毒的分子诊断]

[Molecular diagnosis of influenza A(H1N1) 2009 virus and other respiratory viruses during the first pandemic wave in Cuba].

作者信息

Oropeza Fernández Suset, Acosta Herrera Belsy, Piñón Ramos Alexander, Valdés Ramírez Odalys, Savón Valdés Clara, Arencibia García Amely, Guilarte García Elias, González Muñoz Grehete, Goyenechea Hernández Angel, Muné Jiménez Mayra, González Báez Guelsys, Hernández Espinosa Bárbara, Guzmán Tirado María G, Llop Hernández Alina

机构信息

Instituto de Medicina Tropical "Pedro Kourí", La Habana, Cuba.

出版信息

Rev Cubana Med Trop. 2011 May-Aug;63(2):147-54.

Abstract

INTRODUCTION

the first pandemic virus of the 21st century - the influenza A (H1N1)/2009 virus-appeared in Mexico in April 2009 after triple reassortment of influenza strains of avian, human and pig origin and from there, it was spread worldwide. With the purpose of facing up to this event, Cuba adopted antipandemic measures including the virology surveillance using all necessary actions.

OBJECTIVES

the detection and validation of the entry of the causative agent of pandemic into the country in a fast and timely way, in addition to the definition of involvement of other viruses in the etiology of acute respiratory infections.

METHODS

as a result of the lab surveillance, from the 38th to the 42nd epidemiological weeks (September and October, 2009), 1 063 respiratory clinical samples were processed (nasopharyngeal exudates, bronchial aspirates and lung necropsy samples). The highest number of confirmed cases caused by the new virus was detected in this period that represented the first pandemic wave in Cuba. Diagnosis was based on molecular diagnosis algorithm.

RESULTS

out of the 1063 samples, 597 (56.0 %) were positive. The pandemic influenza A (H1N1) virus was the most commonly detected etiological agent in 306 suspected cases (51 %) followed by influenza A (H3N2) virus in 228 cases (38 %). Other respiratory viruses were diagnosed in 63 clinical samples (11 %). The pandemic virus was confirmed in 50 pregnant women. Rhinoviruses were identified more frequently in those samples from patients with clinical diagnosis of bronchial pneumonia and broncholitis. Morbidity increased during this period; 225 825 medical consultations were notified due to acute respiratory infections mid-October 2009.

CONCLUSIONS

the molecular diagnosis algorithm proved to be sensitive, specific and effective to assure the systematic virological surveillance in our country during the pandemic phase.

摘要

引言

2009年4月,21世纪的第一种大流行病毒——甲型H1N1流感/2009病毒——在墨西哥出现,它是由禽、人、猪源流感毒株三重重组而成,随后传播至全球。为应对这一事件,古巴采取了包括通过一切必要行动进行病毒学监测在内的抗疫措施。

目的

快速及时地检测和确认大流行病原体进入该国,并确定其他病毒在急性呼吸道感染病因中的作用。

方法

作为实验室监测的结果,在第38至42个流行病学周(2009年9月和10月),共处理了1063份呼吸道临床样本(鼻咽分泌物、支气管吸出物和肺尸检样本)。在此期间检测到由这种新病毒引起的确诊病例数量最多,这代表了古巴的第一波大流行。诊断基于分子诊断算法。

结果

在1063份样本中,597份(56.0%)呈阳性。甲型H1N1流感大流行病毒是306例疑似病例(51%)中最常检测到的病原体,其次是甲型H3N2流感病毒,有228例(38%)。在63份临床样本(11%)中诊断出其他呼吸道病毒。在50名孕妇中确诊了大流行病毒。在临床诊断为支气管肺炎和支气管炎的患者样本中,鼻病毒的检出频率更高。在此期间发病率上升;2009年10月中旬,因急性呼吸道感染通报了225825次医疗咨询。

结论

分子诊断算法在大流行阶段对确保我国系统的病毒学监测被证明是灵敏、特异且有效的。

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