某中学一起聚集性集中发热事件流行病学分析  

Epidemiological investigation and analysis to the field of aggregation of heating case in a middle school

作　　者：马燕玲[1] 解艳涛[1] 宁召起[1] 苏彦萍[1] 赵春艳[1] 徐颖[1] 刘秀军[1] 李红军 

机构地区：[1]北京市通州区疾病预防控制中心,101100

出　　处：《中国学校卫生》2012年第8期973-975,共3页Chinese Journal of School Health

摘　　要：目的分析某中学聚集性集中发热病例特征,探讨其流行病学危险因素、传播形式和病原体,为今后暴发疫情的处理提供依据。方法采用描述性方法对病例特征进行流行病学分析,检测病例麻疹、风疹IgM抗体,用PCR进行呼吸道多病原检测。结果共搜索131例发热病例,罹患率为8.7%(131/1 506)。发病高峰在4月17-19日。主要临床症状为发热(100.0%)伴头痛(55.0%)、咽痛(42.0%)、咳嗽(22.9%)、皮疹(40.0%)。病例集中发生在高一年级,其中高一(1)班罹患率高达45.2%。对病例间接触、校内、校外就餐等暴露因素进行单因素分析,暴露因素与疾病发生的关联强度均无统计学意义。麻风疫苗应急接种为此次暴发疫情的保护性因素(RR=0.38χ,2=2.31,P=0.000)。对18例急性期出疹病例进行麻疹、风疹双份血清IgM抗体检测均为阴性;8份咽拭子标本经呼吸道多病原检测均为阴性。结论根据流行病学史和临床诊断不能完全排除风疹、麻疹等病毒感染的可能。根据病例主要症状及实验室检查结果的临床特征,不排除细菌感染的可能性。Objective To analyze the feature of aggregation of centralized heating cases in a high school, and to explore the epidemiologieal risk factors, the mode of transmission and the pathogens. Methods By using the descriptive method to analyze the epidemiology character, and the IgM antibody of measles and rubella virus were tested, the respiratory multi-pathogens were detected by PCR test. Results A total of 131 cases of fever were collected, with the incidence rate 8.7% { 131/1 506）. The peak of incidence was during April 17th-19th, the main clinical symptoms were fever（ 100.0% ） , with headache （55.0%） , throat sore （ 42.0% ） , cough （ 22.9% ） , and rash （ 40% ）. The cases mainly occurred in senior school grade one, with a high rate up to 45.2%. In single factor analysis by case contact, intramural, extramural dining and other exposure factors, the results showed the correlation degree of exposure factors associated with no statistical significance in the occurrence of the disease. Though leprosy vac- cine emergency vaccination analysis for the group of grade one, results were protective factors （ RR = 0.38 ,X2 = 2.31, P = 0.000 }. On 18 cases of acute period of measles and rubella rash cases, paired serum IgM antibody test were negative, 8 throat swab speci- mens of respiratory tract multiple pathogenic test were negative. Conclusion According to the case mainly for fever, headache, sore throat, rash and other upper respiratory symptoms and 27.3 % cases of Neutrophils ratios clinical features, take all into consideration, it can＇t rule out the possibility of bacterial infection.

关 键 词：发热 疾病暴发流行 流行病学研究 学生 

分 类 号：R174.6[医药卫生—妇幼卫生保健]