2015—2024年上海市普陀区成人流感样病例中呼吸道病毒病原谱及流行特征

Analyses of pathogen spectrum and epidemiological characteristics of respiratory viruses in adult influenza-like illness cases in Putuo District of Shanghai from 2015 to 2024

    摘要
  • 摘要:
    目的 探讨2015—2024年上海市普陀区成人流感样病例（ILI）中呼吸道病毒感染病原谱构成及流行特征，寻找呼吸道病毒在不同时间、人群中的流行规律，为上海市普陀区成人呼吸道病毒感染防控提供科学依据。
    方法 回顾性收集2015—2024年上海市普陀区急性呼吸道感染综合监测哨点医院2 273例成人ILI监测数据资料，使用描述性流行病学方法，分析流感病毒、呼吸道合胞病毒、腺病毒、人偏肺病毒等呼吸道病毒的时间、人群分布特征，比较不同年龄组人群混合感染情况，以及对流感病毒亚型分布特征进行描述，使用SPSS 22.0和WPS Office软件进行统计分析。
    结果 2 273例成人ILI中呼吸道病毒总检出率为43.51%。女性检出率（45.48%）高于男性（41.25%），差异有统计学意义（χ2=4.113，P=0.043）；60岁及以上人群检出率（47.41%）居年龄组别之首（χ2=8.430，P=0.014）；冬季（50.41%）、夏季（48.42%）检出率高于其他季节（χ2=47.028，P<0.001）。2020年后检出率有所下降（χ2=208.411，P<0.001）。不同年份各病毒检出率有所不同，其中流感病毒和腺病毒在2015—2019年检出率较高（均P<0.001），普通冠状病毒和鼻/肠病毒在2020—2022年检出率较高（均P<0.001）。流感病毒混合普通冠状病毒感染最为常见，流感病毒混合腺病毒感染次之，共占所有混合感染的50.00%。监测期间，流感病毒检出率高于其他呼吸道病毒，其中2021年以B/Victoria系为主，2022至2023年先后转为甲型H1N1、H3N2及两种亚型共同流行，2024上半年再度以甲型H1N1亚型为主。
    结论 2015—2024年成人呼吸道病毒感染以冬、夏季为主，60岁及以上人群为主要感染对象，2020年后各呼吸道病毒检出率有所下降，其中流感病毒为主要检出病原体，且各年度流感病毒不同亚型交替流行。

     

    Abstract:
    Objective To analyze the composition of respiratory virus pathogen spectrum and epidemiological characteristics among adult influenza-like illness (ILI) cases in Putuo District of Shanghai from 2015 to 2024, to summarize the epidemic patterns of respiratory viruses across different time periods and populations, and to provide scientific evidence for the prevention and control of adult respiratory virus infections in Putuo District of Shanghai.
    Methods Surveillance data of 2 273 adult ILI cases from sentinel hospitals under the comprehensive surveillance system for acute respiratory infections in Putuo District of Shanghai from 2015 to 2024 were retrospectively collected. Descriptive epidemiological methods were adopted to analyze the temporal and population distribution characteristics of respiratory viruses, including influenza virus (IFV), respiratory syncytial virus (RSV), adenovirus (ADV), and human metapneumovirus (HMPV). The mixed infection status among different age groups was compared, and the distribution of influenza virus subtypes was described. SPSS 22.0 and WPS Office software were used for statistical analyses.
    Results The overall detection rate of respiratory viruses in 2 273 adult ILI cases was 43.51%. The detection rate in females (45.48%) was significantly higher than that in males (41.25%), with statistical significance (χ2=4.113, P=0.043). Individuals aged 60 years old and above had the highest detection rate (47.41%) (χ2=8.430, P=0.014). The detection rates in winter (50.41%) and summer (48.42%) were higher than those in other seasons (χ2=47.028, P<0.001). The overall viral detection rate decreased after 2020 (χ2=208.411, P<0.001). Detection rates of various viruses varied by year, with IFV and ADV showing high rates from 2015 to 2019 (all P<0.001), while human coronavirus (HCoV) and rhinovirus/enterovirus (HRV/EV) exhibited higher rates from 2020 to 2022 (all P<0.001). Co-infection with IFV and HCoV was the most common, followed by co-infection with IFV and ADV, together accounting for 50.00% of all mixed infections. During the surveillance period, the detection rate of IFV was significantly higher than that of other respiratory viruses. Influenza B/Victoria lineage predominated in 2021, followed by successive predominance of influenza A(H1N1), A(H3N2), and the co-circulation of the two subtypes from 2022 to 2023. Influenza A(H1N1) re-emerged as the predominant subtype in the first half of 2024.
    Conclusion From 2015 to 2024, respiratory virus infections in adults prevailed in winter and summer, and people aged 60 years old and above were the key high-risk population. The detection rates of respiratory viruses declined after 2020. IFV was the predominant pathogen detected, and different influenza virus subtypes circulated alternately each year.

     

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