Analysis on the epidemiological characteristics of severe and fatal cases of influenza in Chongqing from 2017 to 2020

doi:10.3969/j.issn.1672-2302.2023.05.007

Abstract

Abstract:

Objective To analyze the epidemiological characteristics of severe, critical and fatal cases of influenza in Chongqing Municipality for evidences for prevention and control of severe influenza. Methods The data of severe, critical and fatal cases of influenza reported in Chongqing Municipality were retrieved from 2017 to 2020 via the China Disease Prevention and Control Information System, and analyzed using descriptive epidemiology pertinent to the distribution of time, region and population as well as the past medical history of the patients and clinical manifestations of the infection. Results A total of 164 severe, critical and fatal cases of influenza were reported from 2017 to 2020 in Chongqing Municipality. The infection was most seen from December to March of the following year. Influenza A virus was the dominant virus (n=157 cases, 95.73%). By population distribution, 111 were males and 53 females. The infection most occurred in patients aged 60-69 years (n=34 cases, 20.73%), and farmers (n=56 cases, 34.15%). The 164 cases were distributed in 19 counties/districts, and the most reported was in Yuzhong District (n=101 cases), Dianjiang County (n=11 cases) and Nan'an District (n=6 cases). 58.54% (96/164) of the 164 cases had previous medical history. The main clinical manifestations were cough (n=159 cases), abnormal breath sounds (n=134 cases) and fever (n=129 cases). The most common complication was pneumonia (n=134 cases, 81.71%). Conclusion The high incidence of severe influenza and death in Chongqing generally occurs winter and spring seasons, with influenza A virus being the major pathogen. The severe infection is relatively higher in elderly and males. The findings suggest that the influenza vaccination rate should be increased, and attention should be paid to the progression of the disease among the high-risk groups.

Key words: Influenza, Severe cases, Epidemiological characteristics, Chongqing Municipality

CLC Number:

R511.7

XIONG Yu, QI Li, LI Qin, LI Baisong, WANG Ju. Analysis on the epidemiological characteristics of severe and fatal cases of influenza in Chongqing from 2017 to 2020[J]. Journal of Tropical Diseases and Parasitology, 2023, 21(5): 273-277,286.

Figures/Tables 5

Figure 1

Table 1

Table 2

Table 3

Table 4

Comparison of medical history and clinical information among severe, critical and fatal influenza cases in Chongqing, 2017-2020

特征	重症病例（n=49）		危重症病例（n=79）		死亡病例（n=36）		合计（n=164）		χ²值	P值
特征	病例数（例）	构成比（%）	病例数（例）	构成比（%）	病例数（例）	构成比（%）	病例数（例）	构成比（%）	χ²值	P值
既往病史
慢性呼吸系统疾病	7	14.29	22	27.85	5	13.89	34	20.73	4.70	0.095
心血管疾病	8	16.33	20	25.32	12	33.33	40	24.39	3.33	0.190
代谢性疾病	5	10.20	7	8.86	9	25.00	21	12.80	6.19	0.045
慢性肝/肾病	5	10.20	9	11.39	4	11.11	18	10.98	0.05	0.978
免疫抑制状态*	10	20.41	6	7.59	1	2.78	17	10.37	8.20	0.017
临床表现
发热（≥38 $℃$ ）	37	75.51	66	83.54	26	72.22	129	78.66	2.30	0.316
咳嗽	47	95.92	76	96.20	36	100.00	159	96.95	1.50	0.482
咽痛	20	40.82	27	34.18	16	44.44	63	38.41	1.27	0.529
气短或呼吸困难	16	32.65	70	88.61	29	80.56	115	70.12	47.59	<0.001
气促	25	51.02	63	79.75	35	97.22	123	75.00	25.46	<0.001
异常呼吸音	33	67.35	71	89.87	30	83.33	134	81.71	10.35	0.006
并发症
肺炎	27	55.10	72	91.14	35	97.22	134	81.71	33.71	<0.001
呼吸衰竭	0	0	78	98.73	33	91.67	111	67.68	146.91	<0.001
急性呼吸窘迫综合征	7	14.29	40	50.63	25	69.44	72	43.90	28.44	<0.001
心力衰竭	1	2.04	18	22.78	15	41.67	34	20.73	20.22	<0.001
肾功能不全	1	2.04	11	13.92	17	47.22	29	17.68	30.58	<0.001
肝功能不全	5	10.20	26	32.91	18	50.00	49	29.88	16.36	<0.001
弥漫性血管内凝血	7	14.29	8	10.13	3	8.33	18	10.98	0.87	0.649
感染中毒性休克	0	0	7	8.86	13	36.11	20	12.20	26.86	<0.001

Table 4

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县（区）	重症病例（n=49）		危重症病例（n=79）		死亡病例（n=36）		合计（n=164）
县（区）	病例数（例）	构成比（%）	病例数（例）	构成比（%）	病例数（例）	构成比（%）	病例数（例）	构成比（%）
渝中区	37	75.51	51	64.56	13	36.11	101	61.59
垫江县	0	0	10	12.66	1	2.78	11	6.71
南岸区	0	0	5	6.33	1	2.78	6	3.66
江北区	0	0	3	3.80	2	5.56	5	3.05
梁平区	1	2.04	0	0	4	11.11	5	3.05
巫山县	0	0	4	5.06	1	2.78	5	3.05
云阳县	4	8.16	1	1.27	0	0	5	3.05
铜梁区	3	6.12	0	0	1	2.78	4	2.44
酉阳县	3	6.12	0	0	1	2.78	4	2.44
巴南区	1	2.04	2	2.53	0	0	3	1.83
黔江区	0	0	1	1.27	2	5.56	3	1.83
江津区	0	0	1	1.27	1	2.78	2	1.22
九龙坡区	0	0	0	0	2	5.56	2	1.22
秀山县	0	0	0	0	2	5.56	2	1.22
长寿区	0	0	0	0	2	5.56	2	1.22
丰都县	0	0	1	1.27	0	0	1	0.61
合川区	0	0	0	0	1	2.78	1	0.61
开州区	0	0	0	0	1	2.78	1	0.61
石柱县	0	0	0	0	1	2.78	1	0.61