湖南省郴州市一起新型冠状病毒肺炎聚集性疫情流行病学调查  

Epidemiological survey of a coronavirus disease 2019 cluster in Chenzhou,Hu'nan

作　　者：李频 廖斌 陈柏塘[1] 夏云磊[2] 李雄豹 陈伟华[1] 谭徽[1] LI Pin;LIAO Bin;CHEN Botang;XIA Yunlei;LI Xiongbao;CHEN Weihua;TAN Hui(Chenzhou Center for Disease Control and Prevention,Chenzhou,Hu'nan 423000,China;Zixing Center for Disease Control and Prevention,Chenzhou,Hu'nan 423400,China)

机构地区：[1]郴州市疾病预防控制中心,湖南郴州423000 [2]资兴市疾病预防控制中心,湖南郴州423400

出　　处：《中国热带医学》2020年第8期743-745,共3页China Tropical Medicine

摘　　要：目的通过分析郴州市一起新冠肺炎聚集性疫情相关病例发病确诊过程,探讨新冠病例早发现、早报告以及病例诊断和隔离观察解除的策略依据。方法对该起新冠肺炎聚集性疫情的病例和密切接触者进行现场流行病学调查,描述性分析流行病学史、临床和实验室资料。结果利用大数据比对监测,在转送监测对象至集中场所隔离医学观察时发现了新冠肺炎确诊病例何某华,由此发现一起新冠肺炎家庭聚集性疫情,何某的5名密切接触者中有3人发病确诊(包含1名重症病例),其中重症病例黄某第7次新型冠状病毒核酸检测阳性进而确诊,密切接触者中胡某有流行病学史、血常规白细胞下降和肺炎影像学改变,但是5次咽拭子核酸检测阴性,未确诊。结论大数据比对监测对发现传染病有积极作用;早期对有流行病学史人员单独隔离医学观察对防止聚集性疫情发生有重要意义;将2次核酸检测阴性作为新冠肺炎病例的排除标准和将核酸检测阳性作为确诊新冠肺炎病例的必备条件,值得探讨,这都可能放走传染源,导致新冠肺炎传播。Objective To analyze the coronavirus disease 2019(COVID-19)cluster diagnosis process in Chenzhou city,and we explore the early detection and early report of COVID-19 cases and the strategy basis for case diagnosis and relief.Methods The COVID-19 epidemic cases and close contacts were investigated by field epidemiology,and descriptive epidemiological analysis,clinical and laboratory data were collected.Results Using big data comparison monitoring,a confirmed COVID-19 case named He Mouhua was found when the surveillance subjects were transferred to the central place for medical observation,this led to the discovery of a COVID-19 family cluster.The 3 cases in 5 close contacts of He Mouhua were diagnosed(including 1 severe cases).And the severe case,Huang Mou was confirmed by the seventh SARS-CoV-2 nucleic acid test positive.Hu Mou had a history of epidemiology,a decrease in blood routine leukocytes and an imaging change of pneumonia,but five times of nucleic acid test of pharyngeal swab was negative,which was not confirmed.Conclusion Big data comparison monitoring plays a positive role in the detection of infectious diseases;Early isolation of personnel with medical history by epidemiological is of great significance to prevent the occurrence of cluster epidemic.Negative detection of the 2 times nucleic acid as a exclusion criteria for the diagnosis of COVID-19 and positive detection of nucleic acid as a necessary condition for the diagnosis of COVID-19 are worth exploring,which may lead to the transmission of infectious sources,and COVID-19 spreads.

关 键 词：新冠肺炎 聚集性疫情 密切接触者 大数据比对 

分 类 号：R563.14[医药卫生—呼吸系统]