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健康周刊

Influenza (Seasonal)

季节性流感

Signs and symptoms

体征和症状

Seasonal influenza is characterized by a sudden onset of fever, cough (usually dry), headache, muscle and joint pain, severe malaise (feeling unwell), sore throat and a runny nose. The cough can be severe and can last 2 or more weeks. Most people recover from fever and other symptoms within a week without requiring medical attention. But influenza can cause severe illness or death especially in people at high risk .

季节性流感的特征是突发高热，咳嗽（通常是干咳），头痛，肌肉和关节痛，严重身体不适（感觉不适），咽痛和流鼻涕。咳嗽可以很严重，可持续两周或两周以上。多数人在一周内康复，发热和其它症状消失，无需就医。但流感可导致严重疾病或死亡，特别是在高风险人群中。

Illnesses range from mild to severe and even death. Hospitalization and death occur mainly among high risk groups. Worldwide, these annual epidemics are estimated to result in about 3 to 5 million cases of severe illness, and about 290 000 to 650 000 respiratory deaths.

病情从轻度到重度甚至死亡，严重程度不等。住院和死亡主要发生在高危人群中。据估计，在全球范围内，流感流行每年造成约300万至500万严重病例，约29万至65万例与呼吸道疾病相关的死亡。

In industrialized countries most deaths associated with influenza occur among people age 65 or older (1). Epidemics can result in high levels of worker/school absenteeism and productivity losses. Clinics and hospitals can be overwhelmed during peak illness periods.

在发达国家，大多数与流感相关的死亡发生在65岁及以上人群中(1)。流感流行可使大量员工无法上班，大量学生缺课，生产力下降。流感高峰期间，诊所和医院会不堪重负。

The effects of seasonal influenza epidemics in developing countries are not fully known, but research estimates that 99% of deaths in children under 5 years of age with influenza related lower respiratory tract infections are found in developing countries (2).

关于季节性流感流行对发展中国家的确切影响所知甚少，但有研究显示，因流感导致下呼吸道感染而死亡的5岁以下儿童中，99%是发展中国家儿童(2)。

Diagnosis

诊断

The majority of cases of human influenza are clinically diagnosed. However, during periods of low influenza activity and outside of epidemics situations, the infection of other respiratory viruses e.g. rhinovirus, respiratory syncytial virus, parainfluenza and adenovirus can also present as Influenza-like Illness (ILI) which makes the clinical differentiation of influenza from other pathogens difficult.

大部分流感病例可根据临床表现进行诊断。但在流感低活动期和流行期之外，因感染如鼻病毒、呼吸道合胞病毒、副流感病毒和腺病毒等其它呼吸道病毒也可表现为流感样疾病，这使在临床上不易鉴别流感与其他病原体感染。

Collection of appropriate respiratory samples and the application of a laboratory diagnostic test is required to establish a definitive diagnosis. Proper collection, storage and transport of respiratory specimens is the essential first step for laboratory detection of influenza virus infections. Laboratory confirmation of influenza virus from throat, nasal and nasopharyngeal secretions or tracheal aspirate or washings is commonly performed using direct antigen detection, virus isolation, or detection of influenza-specific RNA by reverse transcriptase-polymerase chain reaction (RT-PCR). Various guidance on the laboratory techniques is published and updated by WHO. (3)

为明确诊断，需采集合适的呼吸道样本进行实验室检验。正确采集、储存和运输呼吸道标本是实验室检验重要的第一步。通常采集喉部、鼻腔和鼻咽分泌物或气管吸出物或洗液作为实验标本，利用直接抗原检测、病毒分离或逆转录酶-聚合酶链式反应（RT-PCR）等方法，检测流感特异性RNA，通过实验室方法确认流感病毒。世卫组织出版并不断更新关于实验室技术的各种指南(3)。

Rapid influenza diagnostic tests (RIDTs) are used in clinical settings, but they have lower sensitivity compared to RT-PCR methods and their reliability depends largely on the conditions under which they are used.

在临床上可使用快速流感诊断试验。但与RT-PCR方法相比，快速流感诊断试验灵敏度较低，可靠性在很大程度上取决于实验条件。

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