武汉市一起新冠确诊病例出院后家庭再现病例调查  

Investigation of family reappear cases after discharge of a COVID-19 case in Wuhan City

作　　者：马兰 柳赟昊 张玲 谢淑云[4] 张雪峰[3] 吴晓旻[2] MA Lan;LIU Yun-hao;ZHANG Ling;XIE Shu-yun;ZHANG Xue-feng;WU Xiao-min(Department of Environmental Health and Occupational Medicine,School of Public Health,Wuhan University of Science and Technology,Wuhan 430065,China;Institute of Environmental Health and Food Hygiene,Wuhan Center for Disease Control and Prevention,Wuhan 430024,China;Jiangsu Provincial Center for Disease Control and Prevention,Jiangsu 210009,China;Zhejiang Provincial Center for Disease Control and Prevention,Zhejiang 310051,China)

机构地区：[1]环境卫生与职业医学系,武汉科技大学医学院公共卫生学院,武汉430065 [2]环境健康与食品卫生所,武汉市疾病预防控制中心,武汉430024 [3]江苏省疾病预防控制中心,210009 [4]浙江省疾病预防控制中心,310051

出　　处：《中华疾病控制杂志》2020年第11期1343-1347,共5页Chinese Journal of Disease Control & Prevention

基　　金：湖北省高等学校优秀中青年科技创新团队计划(T2020003)。

摘　　要：目的分析新型冠状病毒肺炎(COVID-19)确诊病例出院后家庭再现病例的流行病学特征,为家庭聚集性疫情防控提供依据。方法采用现场流行病学调查方法,收集疫情相关人员基本信息、暴露史、发病情况和临床诊疗资料等,分析家庭聚集性疫情感染来源和传播模式。结果本起家庭聚集性疫情中,有3名病例和1人核酸检测阳性。感染来源最大可能来自医院暴露,后续家庭内传播。首发病例C出院时可能未"痊愈",家庭内再现病例的发病时间可能远早于其报告的"发病"时间,未发现支持出院后传播的证据。结论建议强化流行病学调查,并综合临床、实验室等结果进行综合研判,落实密切接触者集中隔离医学观察和病人家庭终末消毒。Objective To analyze the epidemiological characteristics of coronavirus disease 2019(COVID-19)in a family cluster after a patient was discharged from hospital,and to provide recommendations for prevention and control of familial aggregation of COVID-19.Methods On-site epidemiological investigation was conducted to collect personal information,exposure history,morbidity,and clinical information of the COVID-19 patients and close contacts.Based on the data,the source of the COVID-19 virus and transmission mode were further analyzed.Results There were 3 cases and 1 person tested positive for nucleic acid of the virus in the familial aggregation of COVID-19 infection.The most likely source of infection came from hospital exposure and subsequent transmission among family members.Case C,as the first case,maybe a deceptive cure when she was discharged from hospital.The time of recurrence in the family might be much earlier than the reported time of symptom onset.No evidence was found to support the spread of COVID-19 after her discharge.Conclusions It is recommended to strengthen epidemiological investigation,comprehensively analyze clinical and laboratory results,quarantine close contacts of COVID-19 confirmed cases for medical observation,and carry out terminal disinfection of patients’households.

关 键 词：新型冠状病毒肺炎 家庭聚集性 调查 

分 类 号：R183.3[医药卫生—流行病学] R563.1[医药卫生—公共卫生与预防医学]