麻疹疫情流行病学调查与预防控制  

Epidemiological investigation of measles epidemic and prevention and control

作　　者：杨慧宁[1] 张开[2] 王藩[2] 杨轶[2] 孙晓萌[2] 张娜[1] 张本娜[1] 刘海峰[2] 

机构地区：[1]武警总医院感染控制科,北京100039 [2]武警总医院医务部,北京100039

出　　处：《中华医院感染学杂志》2016年第11期2625-2627,共3页Chinese Journal of Nosocomiology

基　　金：武警部队后勤部卫生部基金资助项目(WJHQWSB2013-06)

摘　　要：目的调查医院麻疹疫情流行病学特征及原因,有针对性地制定预防控制策略,为预防医院感染提供科学依据。方法回顾性调查医院2014年2月7日-3月7日发生的38例麻疹疫情以及患者临床资料,采用描述性研究方法分析麻疹疾病在医院的流行特征。结果医院麻疹确诊病例共计38例,其中包括临床诊断病例21例,实验室诊断病例17例,麻疹病毒IgM抗体或咽拭子检测均呈阳性;病例最先发生且主要集中在细胞移植科共32例,感染者为住院患者、患者家属、医师及护士;第2、3例患者与第1例患者均有明确的流行病学接触史,随后相继发病的患者房间相邻,时间不超过麻疹的平均潜伏期;其他科室散发7例,其中心内科1例有流行病学接触史;以上所有病例均无麻疹疫苗接种史,平均23岁。结论根据实验室、临床诊断及流行病学史,此次事件是一起由麻疹病毒引起的医院感染暴发疫情,应当加强医务人员对常见传染病诊断知识及传染病上报流程培训,切实提高传染病上报意识,还应注重手卫生及标准预防与监测。OBJECTIVE To investigate the epidemiological characteristics and causes of measles epidemic in the hospital and put forward targeted control strategies so as to provide scientific basis for prevention of nosocomial infections.METHODS The clinical data of 38 patients with measles epidemic who were treated in the hospital from Feb7,2014 to Mar 7,2014 were retrospectively investigated,and the epidemiological characteristics of the measles were analyzed by using descriptive study method.RESULTS Of totally 38 patients with confirmed measles,21 were clinically diagnosed,and 17 were diagnosed by the laboratory;all the patients were detected positive for measles virus IgM antibody or throat swab.Totally 32 patients distributed in the cell transplantation department in the very benining,and the hospitalized patients,family members of patients,doctors,and nurses were the major populations.The case 2and case 3had the explicit epidemiological history of exposure to the case 1,then,the patients,the wards of whom were adjacent,subsequenctly had the disease,and the onset time was not longer than the average incubation period of measles;7sporadic cases distributed in other departments,and 1case of the cardiology department had the epidemiological history of exposure.All of the above cases did not have the history of measles vaccination,and the average age was 23 years old.CONCLUSIONBased on the clinical laboratory,clinical diagnosis,and epidemiological history,the incident is an epidemic of nosocomial infection caused by the measles virus.It is necessary to strengthen the training of report process of infectious diseases and diagnosis of common infectious diseases for the health care workers,effectively improve the awareness of report of infectious diseases,and focus on hand hygiene,standard prevention,and surveillance.

关 键 词：医院感染 麻疹 暴发 流行病学 

分 类 号：R511.1[医药卫生—内科学]