基于流感样病例监测评估新冠疫情对温州某医院流感流行特征的影响

Assessment of influence of COVID-19 epidemic on epidemiological characteristics of influenza in a hospital of Wenzhou based on surveillance of influenza-like cases

    摘要
  • 摘要:
    目的  分析2017-2024年温州某医院流感监测数据，了解新冠疫情防控对流感流行病学特征的影响，为科学制定流感防控措施提供依据。
    方法  回顾性分析2017年1月-2024年6月流感样病例(ILI)咽拭子样本的流感病毒抗原检测结果，将检测结果按照新冠疫情前期(2017年1月-2019年12月)、新冠疫情防控期(2020年1月-2022年12月)、后新冠疫情时期(2023年1月-2024年6月)分组来分析流感流行病学特征变化。
    结果  2017年1月-2024年6月共采集ILI样本115 751例，2020-2022年ILI急剧下降；2017-2019年甲型流感检出率逐年上升(χ 2=782.36, P＜0.001)，乙型流感检出率逐年下降(χ 2=1120.91, P＜0.001)；2020-2022年甲型流感检出率下降到最低为0.19%，2023-2024年6月甲型流感检出率上升到最高为42.73%，而乙型流感未明显受到疫情防控的影响；2017-2019年、2020-2022年、2023-2024年6月的ILI最高的年龄段分别为2岁、5岁、6岁，有逐渐升高趋势；2017-2019年、2020-2022年、2023-2024年6月在1~11岁年龄段的ILI数量占比分别为72.06%、55.31%、41.93%，呈现逐年下降趋势(χ 2=7763.4, P＜0.001)；2017-2024年6月监测年度内ILI流行高峰主要分布在冬春季节，在2022年新冠疫情防控期出现6月、7月ILI流行高峰；2017-2020年各年龄段甲型流感最高检出率逐渐升高(χ 2=294.67, P＜0.001)，2021年甲型流感最高检出率下降到0.46%，2022年最高检出率升高到50.69%；2017-2024年6月各年龄段乙型流感最高检出率呈现规律的上下波动，最高检出率的年龄段均维持在＞6~≤12岁。
    结论  新冠疫情防控对流感流行病学特征具有重要影响，其中对甲型流感影响比较显著，发病人群年龄结构有较大变化，流感样病例年龄有升高的趋势。

     

    Abstract:
    OBJECTIVE  To analyze the influenza surveillance data of a hospital in Wenzhou from 2017 to 2024, gain an insight into the impact of the prevention and control of COVID-19 on the epidemiological characteristics of influenza, and provide an evidence for scientifically developing influenza prevention and control strategies.
    METHODS  The influenza virus antigen detection results of throat swab specimens from influenza-like illness (ILI) cases from Jan. 2017 to Jun. 2024 were retrospectively analyzed. Different epidemiological characteristics of influenza were analyzed at the early stage (2017.1 to 2019.12), the prevention and control stage (2020.1 to 2022.12) and the post COVID-19 epidemic stage (2023.1 to 2024.6).
    RESULTS  A total of 115, 751 ILI specimens were collected from Jan. 2017 to Jun. 2024 with a sharp decline in 2020-22. From 2017 to 2019 the detection rate of influenza A increased year by year (χ 2=782.36, P < 0.001), while influenza B decreased (χ 2=1120.91, P < 0.001); the detection rate of influenza A decreased to a minimum of 0.19% in 2020-22, and rose to a maximum of 42.73% in Jun. 2023-2024, while influenza B was not significantly affected by epidemic prevention and control. The maximum quantities for ILI in 2017-19, 2020-22, and 2023-24 are showed at the age of 2-, 5- and 6-years old, respectively, with a gradually increasing trend on age; meanwhile, the proportion of ILI cases at the age of 1 to 11 years during 2017-19, 2020-22 and 2023- Jun. 2024 was 72.06%, 55.31%, and 41.93%, respectively, with a decreasing trend year by year (χ 2=7763.4, P < 0.001). The epidemic peaks of ILI mainly distributed in winter and spring, but the peak time occurred in Jun. and Jul. during the COVID-19 prevention and control period in 2022. The highest detection rate of influenza A in various age groups gradually increased from 2017 to 2020 (χ 2=294.67, P < 0.001). In 2021, the highest detection rate of influenza A decreased to 0.46%, and in 2022 increased to 50.69%. The highest detection rate of influenza B in various age groups showed regular fluctuations from 2017 to Jun. 2024, and the age range with the highest detection rate remained at > 6-≤12 years old.
    CONCLUSIONS  The prevention and control of the COVID-19 had an important impact on the epidemiological characteristics of influenza, especially influenza A. The age structure had changed significantly and rising trend was showed for ISI population.

     

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