北京市海淀区某小学肺炎支原体肺炎暴发疫情调查分析  

Investigation and Analysis of a Mycoplasma Pneumoniae Pneumonia Infection Outbreak in a Primary School in Haidian,Beijing

作　　者：陈春枝 蔡伟[1] 王菊光[1] 韦懿芸[1] 张恒 史凤琳 侯威远[1] 赵振[1] CHEN Chunzhi;CAI Wei;WANG Juguang;WEI Yiyun;ZHANG Heng;SHI Fenglin;HOU Weiyuan;ZHAO Zhen(Haidian Center for Disease Control and Prevention,Beijing 100094,China)

机构地区：[1]北京市海淀区疾病预防控制中心

出　　处：《预防医学情报杂志》2020年第1期10-14,共5页Journal of Preventive Medicine Information

摘　　要：目的对2018-06-27/08-03北京市海淀区某小学肺炎支原体感染引起的流感样病例暴发疫情进行调查,分析疫情流行特征,为防控工作提供依据。方法通过现场流行病学调查,搜索病例进行个案调查,采集病例咽拭子标本进行呼吸道多病原核酸检测,采用χ~2检验进行率的比较。结果北京市海淀区某小学共发生肺炎支原体感染临床诊断病例和实验室确诊病例26例,其中学生24例,教师2例,男性罹患率16.83%,女性罹患率10.59%,不同性别罹患率差异无统计学意义(χ^2=1.496,P=0.221);指示病例1(首发病例)6月27日发病,疫情共持续37 d;病例主要集中在四年级1-4班,发病时间集中在07-16至07-22;临床症状以发热、咳嗽为主,均占100%;四年级1-4班罹患率为13.98%,其中四4班罹患率最高为39.13%,班级罹患率差异有统计学有意义(χ^2=33.013,P<0.001);该起疫情结案前病例肺炎支原体核酸阳性率为68.42%,结案后为40.00%,结案后波及人群阳性率为30.00%,三者阳性率差异无统计学意义(χ^2=5.112,P=0.078)。结论肺炎支原体传染性较强,在潜伏期至症状缓解数周仍有传染性,而且导致的无症状感染患者较多,使防控工作面临更严峻的考验,必须及时处置,防止扩散。Objective To investigate the outbreak of Mycoplasma pneumoniae infection in a primary school from June 27 to August 3,2018,and analyze the epidemic characteristics,in order to provide references for disease prevention and control.Methods Field epidemiological investigation and individual survey were conducted.Throat swabs samples were collected for the respiratory multipathogenic nucleic acid detection.Chi-square test was used in rate comparison.Results There were 26 cases,including clinically diagnosed cases and laboratory confirmed cases,infected with Mycoplasma pneumoniae in the school,among them 24 were student cases and 2 were teacher cases.The attack rate in male was 16.83%,that in female was 10.59%,there was no significant difference in the attack rate of Mycoplasma pneumoniae between different genders(χ^2=1.496,P=0.221).Indicator case 1(the first case)occurred on June 27 and the epidemic situation lasted for 37 days.The cases mainly occurred in class 1-4 of grade 4,and the onset time was from July 16 to 22.The main clinical symptoms were fever and cough.The total attack rate of class 1-4,grade 4 was 13.98%,of which class 4 showed the highest attack rate of39.13%.There was a significant difference in the attack rate among different classes(χ^2=33.013,P<0.001).The cases’positive rate of Mycoplasma pneumoniae nucleic acid was 68.42% before the closure of this outbreak,40.00% after closing the case,and 30.00% of the affected population after closing the case.There was no significant difference among these 3 positive rates(χ^2=5.112,P=0.078).Conclusions Mycoplasma pneumoniae is highly infectious,the contagion persists from incubation period to several weeks after symptom relief.Moreover,it causes a large number of asymptomatic infections.All these characteristics make the prevention and control of the Mycoplasma pneumonia epidemic a more severe challenge,the epidemics must be handled in time and prevent its spreading.

关 键 词：肺炎支原体 暴发 

分 类 号：R179[医药卫生—妇幼卫生保健] R725.6[医药卫生—公共卫生与预防医学]