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[2015 - 2016年俄罗斯及全球流行季:流感病毒的传播、发病率趋势、临床情况及治疗方案]

[The 2015-2016 epidemic season in Russia and the world: Circulation of influenza viruses, trends in incidence, clinical aspects, and treatment algorithm].

作者信息

Lvov D K, Kolobukhina L V, Burtseva E I, Kruzhkova I S, Malyshev N A, Fedyakina I T, Kirillova E S, Trushakova S V, Feodoritova E L, Merkulova L N, Krasnoslobodtsev K G, Mukasheva Е A, Garina E O, Vartanyan R V, Kisteneva L B, Prilipov A G, Bazarova M V, Devyatkin A V, Sutochnikova O A

机构信息

D.I. Ivanovsky Institute of Virology, Honorary Acad. N.F. Gamaleya Federal Research Centre for Epidemiology and Microbiology, Ministry of Health of Russia, Moscow, Russia.

Infectious Diseases Hospital One, Moscow Healthcare Department, Moscow, Russia.

出版信息

Ter Arkh. 2016;88(11):112-120. doi: 10.17116/terarkh20168811112-120.

Abstract

In the 2015-2016 epidemic season, there were dominant influenza A(H1N1)pdm09 strains (over 90%) among the circulating influenza viruses in most countries of the Northern Hemisphere and in Russia. A study of the antigenic properties of influenza A(H1N1)pdm09 strains revealed no differences in those of vaccine virus. Sequencing showed that there were amino acid substitutions in hemagglutinin (receptor binding and Sa sites) and in the genes encoding internal proteins (PA, NP, M1, and NS1). The rise in the incidence in the Russian Federation, which was etiologically associated with influenza viruses, was registered in January-February 2016 with its maximum being observed at 4-5 weeks of 2016. Within the framework of the epidemiological surveillance of circulating influenza viruses in the Russian Federation, which was conducted by the WHO European Office, the D.I. Ivanovsky Institute of Virology, Honorary Academician N.F. Gamaleya Federal Research Centre for Epidemiology and Microbiology, Ministry of Health of Russia, and the Research Institute of Influenza, Ministry of Health of Russia, monitored at the Infectious Diseases Hospital One (IDH-1), Moscow Healthcare Department. Among 1491 examinees, influenza was verified in 104 (21.3%) adults, 208 (42.5%) pregnant women, and 177 (36.2%) children. Influenza A(H1N1)pdm09 was more often diagnosed in the age group of 15-40 years (63.7%); the proportion of influenza patients aged over 50 years increased (22.1%). Most adult patients had moderate influenza; pneumonia complicated the disease in 27.4%. Influenza in the pregnant women was complicated by pneumonia in 4.8% of cases. Influenza was more frequently diagnosed in infants and preschool children aged 0 to 3 years (42.9%), 4 to 6 years (41.2%), and older (15.9%), namely: 7-9 years (10%) and 10-12 years (5.9%). Influenza in the children was complicated by acute tonsillitis (19.4%) and varying degrees of laryngeal stenosis (12.4%). Bronchial obstructive syndrome developed in 2.5%, the rate of pneumonia was 6.2%. Antiviral therapy (AVT) in the early stages of the disease reduces the risk of its severity, the frequency of secondary complications, and the duration and degree of clinical symptoms of influenza. AVT with oseltamivir, zanamivir, imidazolyl ethanamide pentandioic acid (ingavirin), and interferon-a2b (viferon) has been performed in the patients hospitalized at Moscow IDH-1 in the 2015-2016 epidemic season.

摘要

在2015 - 2016年流行季节,北半球大多数国家以及俄罗斯流行的流感病毒中,甲型(H1N1)pdm09毒株占主导地位(超过90%)。一项关于甲型(H1N1)pdm09毒株抗原特性的研究表明,其与疫苗病毒的抗原特性并无差异。测序显示,血凝素(受体结合位点和Sa位点)以及编码内部蛋白的基因(PA、NP、M1和NS1)存在氨基酸替换。俄罗斯联邦与流感病毒病因相关的发病率上升情况于2016年1月至2月被记录,发病率最高值出现在2016年的第4 - 5周。在世卫组织欧洲办事处、俄罗斯卫生部病毒学研究所(D.I.伊万诺夫斯基病毒学研究所)、荣誉院士N.F.加马列亚联邦流行病学与微生物学研究中心以及俄罗斯卫生部流感研究所开展的俄罗斯联邦流行流感病毒的流行病学监测框架内,在莫斯科医疗部门的第一传染病医院(IDH - 1)进行了监测。在1491名受检者中,确诊流感的有104名(21.3%)成年人、208名(42.5%)孕妇和177名(36.2%)儿童。甲型(H1N1)pdm09流感在15 - 40岁年龄组中诊断更为常见(63.7%);50岁以上流感患者的比例有所增加(22.1%)。大多数成年患者患中度流感;27.4%的患者病情并发肺炎。孕妇流感病例中有4.8%并发肺炎。流感在0至3岁婴幼儿(42.9%)、4至6岁儿童(41.2%)以及年龄稍大儿童(15.9%)中诊断更为频繁,具体为:7 - 9岁儿童(10%)和10 - 12岁儿童(5.9%)。儿童流感并发急性扁桃体炎(19.4%)和不同程度的喉狭窄(12.4%)。2.5%的患者出现支气管阻塞综合征,肺炎发病率为6.2%。疾病早期进行抗病毒治疗(AVT)可降低病情严重程度、继发并发症的发生率以及流感临床症状的持续时间和严重程度。2015 - 2016年流行季节,在莫斯科IDH - 1住院的患者中使用了奥司他韦、扎那米韦、咪唑基乙酰胺戊二酸(英加韦林)和干扰素 - a2b(维福隆)进行抗病毒治疗。

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