济南市一养老院疥疮暴发事件的流行病学调查  

Epidemiological report of an outbreak of scabies in a nursing home in Jinan

作　　者：槐鹏程 初同胜 李建可[1,2] 暴芳芳 宋平平[1,2] 刘健 张福仁[1,2] HUAI Pengcheng;CHU Tongsheng;LI Jianke;BAO Fangfang;SONG Pingping;LIU Jian;ZHANG Furen(Hospital for Skin Diseases,Shandong First Medical University,Jinan 250022,China;Shandong Provincial Institute of Dermatology and Venereology,Shandong Academy of Medical Sciences,Jinan 250022,China)

机构地区：[1]山东第一医科大学附属皮肤病医院,山东济南250022 [2]山东省皮肤病性病防治研究所,山东济南250022

出　　处：《中国麻风皮肤病杂志》2024年第3期166-169,共4页China Journal of Leprosy and Skin Diseases

基　　金：山东省泰山学者攀登计划(编号:tspd20230608)。

摘　　要：背景:2022年3月13日,济南市某养老院内多人出现疥疮类似症状,我院立即成立调查组赴现场应急处置。目的:对该养老院居住的老年人及护工进行流行病学调查,确认疥疮暴发,分析传染源和传播途径,治疗确诊病人,控制疥疮暴发。方法:对该养老院内发现疥疮患者的一相对隔离的居住区内所有老年人和护工进行问诊、体格检查、皮肤镜检查、显微镜镜检和问卷调查,明确疥疮感染情况和流行特征。应用SPSS16.0软件进行统计学分析。结果:该居住区的46位老年人和9位护工均感染疥疮。46位老年人中男29例、女17例,平均年龄(76.57±13.01)岁30例(65.22%)为疥疮确诊病例16例(34.78%)为疥疮临床诊断病例。9位护工中,男2例、女7例,平均年龄(53.78±5.29)岁2例(22.22%)为疥疮确诊病例7例(77.88%)为疥疮临床诊断病例。55例中,皮损多发生于躯干(52.73%)和手部(47.27%)。传染源系2021年3月1日入住该养老院的一例老年女性疥疮患者。共用洗衣机洗涤被服和衣物是该养老院疥疮传播的主要途径。患者经10%的硫软膏治疗后均已治愈。结论:未对新入住老年人进行疥疮筛查和被服的共同洗涤是造成本次疥疮暴发的主要原因。建议养老院对所有新入住的老年人常规筛查疥疮;建议卫生行政部门将疥疮纳入需要监测的传染病管理,通过监测发现潜在的疥疮暴发风险并及时管控。Background:March 13,2022,many elderly persons in a nursing home in Jinan were reported to have scabies infected symptoms,our hospital immediately set up a team to emergency response.Objective:To confirm the scabies outbreak,analyze the source and route of transmission,treat the diagnosed patients and control the scabies outbreak.Methods:Face to face interview,physical examination,dermoscopy and microscopy were conducted for all elderly persons and caregivers in a residential area of the nursing home with itching symptoms.Explore the number of scabies infected persons and epidemic characteristics.Statistical analysis was performed using SPSS 16.0.Results:Forty six elderly people and 9 nursing workers in the residential area were all infected with scabies.Among the 46 elderly patients,29 were males and 17 were females,with an average age of 76.57±13.01 years.30(65.22%)were confirmed cases of scabies,and 16(34.78%)were clinically diagnosed cases of scabies.Among the 9 nursing workers,2 were males and 7 were females,with an average age of 53.78±5.29 years.2(22.22%)were confirmed cases of scabies,and 7(77.88%)were clinically diagnosed cases of scabies.Most lesions occurred on the torso(52.73%)and hands(47.27%).The source of infection was an elderly female patient with scabies who was admitted to the nursing home on March 1,2021.Sharing washing machines to wash bedding and clothing was the main route of scabies transmission.All patients were cured after treatment with 10%sulfur ointment.Conclusion:The main cause of the outbreak of scabies was the lack of screening for the newly elderly persons who admitted in nursing home.We suggest that the civil affairs department formulate policies to require nursing homes to routinely screen all elderly people for scabies.We suggest the health department formulate policies to require hospitals to surveillance scabies and control outbreak timely.

关 键 词：养老院 疥疮 流行病学调查 

分 类 号：R757.1[医药卫生—皮肤病学与性病学] R181.3[医药卫生—临床医学]