一起加湿器污染引起的庞蒂亚克热型军团病聚集性疫情的调查与分析  

Investigation and analysis on a clustering epidemic of Pontiac Fever Legionnaires′Disease caused by humidifier contamination

作　　者：吴起乐 王利[1] 朱明[1] 高峰[1] 杨锟[1] 陈健 WU Qi-le;WANG Li;ZHU Ming;GAO Feng;YANG Kun;CHEN Jian(Health Emergency Center,Ma'anshan Center for Disease Control and Prevention,Anhui 243000,China)

机构地区：[1]马鞍山市疾病预防控制中心卫生应急中心,安徽243000

出　　处：《医学动物防制》2022年第7期629-632,F0004,共5页Journal of Medical Pest Control

基　　金：2020年中央公共卫生体系建设和重大疫情防控救治体系建设项目实验方案(皖卫财秘[2020]263号);马鞍山市科技局课题(YL-2019-12)。

摘　　要：目的通过对一起加湿器污染引起的庞蒂亚克热型军团病聚集性疫情的调查分析,找出疫情的感染来源及传播途径,规范、有效地做好疫情处置,防止疫情蔓延,为后续调查提供宝贵经验。方法病例个案调查与现场环境卫生学调查同时开展,结合理化与微生物实验室各项检测找出病因,控制疫情。结果本次疫情共搜索到病例12例,罹患率21.43%(12/56),12例病例均出现发热症状。血常规显示白细胞、中性粒细胞绝对值和百分比、超敏C-反应蛋白均明显升高。11例新型冠状病毒和流感病毒核酸检测均为阴性,其中1例病例FilmArray多重核酸检测也为阴性。根据现场作业情况,先后两次环境空气样品中锡、二氧化锡、铜及其化合物、铅及其化合物均未检出。中央空调及加湿器系统均检出嗜肺军团菌,其中9例病例通过血清学检出1例嗜肺军团菌1~7型IgG抗体阳性,1例嗜肺军团菌1~7型IgM抗体阳性。结论通过综合现场流行病学调查情况、实验室检测结果及临床表现,判定本次疫情为加湿器污染引起的庞蒂亚克热型军团病聚集性疫情。Objective To trace to the source of infection and transmission of the epidemic,standardize and effectively handle the epidemic,prevent the spread of the epidemic,and provide valuable experience for the follow-up investigation through the investigation and analysis on a clustering epidemic of Pontiac Fever Legionnaires’Disease caused by humidifier contamination.Methods The case investigation and field environmental hygiene investigation were concurrently implemented,and physical,chemical and microbiological laboratory tests were combined to find out the etiology and control the epidemic.Results A total of 12 cases were reported in the outbreak,with a prevalence rate of 21.43%(12/56),and all the 12 cases showed fever symptoms.Blood routine examination showed that the absolute and proportion of white blood cells(WBC),absolute value and percentage of neutrophils and hypersensitive C-reactive protein were significantly increased.Eleven cases with 2019-nCoV and influenza virus nucleic acid tests were negative,and one case was also negative for multiple FilmArray nucleic acid tests.According to the on-site operation,tin,tin dioxide,copper&its compounds as well as lead and its compounds were not detected in twice ambient air sample tests.Legionella pneumophila was detected in neither air conditioning or humidification system.One out of 9 case was positive for Legionella pneumophila Type 1-7 IgG antibody,and 1 case was positive for Legionella pneumophila Type 1-7 IgM antibody by serological examination.Conclusion The epidemic is determined to be a clustering epidemic of Pontiac Fever Legionnaires’Disease caused by humidifier contamination based on the field epidemiological investigation,laboratory test results and clinical manifestations.

关 键 词：嗜肺军团菌 加湿器 聚集性疫情 调查 分析 

分 类 号：R517.9[医药卫生—内科学]