2023年广东省深圳市某小学一起肺炎支原体肺炎暴发疫情现场调查  

Field investigation of an outbreak of Mycoplasma pneumoniae pneumonia in a primary school in Shenzhen,Guangdong,2023

作　　者：廖静[1] 王梓琪 陈霖祥 郭聪锐[4] 段利娜[4] 朱启诚 吕子全[5] 许玉成[4] Liao Jing;Wang Ziqi;Chen Linxiang;Guo Congrui;Duan Lina;Zhu Qicheng;Lyu Ziquan;Xu Yucheng(Longgang District Center for Disease Control and Prevention,Shenzhen 518172,Guangdong,China;Baoan District Center for Disease Control and Prevention,Shenzhen 518100,Guangdong,China;Luohu District Center for Disease Control and Prevention,Shenzhen 518101,Guangdong,China;Futian District Center for Disease Control and Prevention,Shenzhen 518000,Guangdong,China;Shenzhen Municipal Center for Disease Control and Prevention,Shenzhen 518020,Guangdong,China)

机构地区：[1]深圳市龙岗区疾病预防控制中心,广东深圳518172 [2]深圳市宝安区疾病预防控制中心,广东深圳518100 [3]深圳市罗湖区疾病预防控制中心,广东深圳518101 [4]深圳市福田区疾病预防控制中心,广东深圳518000 [5]深圳市疾病预防控制中心,广东深圳518020

出　　处：《疾病监测》2024年第10期1367-1372,共6页Disease Surveillance

基　　金：深圳市科技计划项目(No.JCYJ20210324124201004)。

摘　　要：目的对2023年广东省深圳市某小学一起肺炎支原体肺炎(支原体肺炎)暴发疫情开展现场流行病学调查,为今后同类型疫情现场防控提供科学依据。方法收集病例基本信息、症状体征等数据,开展卫生学调查和回顾性队列研究,采集咽拭子检测肺炎支原体DNA,并现场检测风速、温度和湿度。结果支原体肺炎共52例,罹患率4.80%。病例主要临床表现为咳嗽(98.08%)和发热(92.31%)。流行曲线呈现增殖模式,首发病例在2023年4月16日发病,疫情持续73 d。病例聚集在2楼、A栋。现场检测显示,A栋风速为(0.06±0.05)m/s,显著低于B栋风速(0.12±0.09)m/s(t=-2.219,P=0.041)。不同楼层风速比较,差异有统计学意义(F=4.030,P=0.033),其中2楼通风最差。A栋和2楼存在通风不良的建筑布局。回顾性队列研究提示,国际象棋第二课堂是疫情传播的危险因素(相对危险度=4.00,95%置信区间:1.08~14.82)。38份咽拭子样本检出8份肺炎支原体DNA阳性。通过2次闭环式现场处置(风险研判+提出措施+追踪落实),疫情得到有效控制。结论本次疫情是一起支原体肺炎暴发疫情,传播途径可能为飞沫传播。建议开展风险研判,及时做好病例报告和隔离,加强通风和个人防护。Objective To understand the epidemiology of an outbreak of Mycoplasma pneumoniae pneumonia in a primary school in Shenzhen,Guangdong province,in 2023,provide evidence of field prevention and control of the similar epidemic in future.Methods The information about basic characteristics,symptoms and signs of the cases were collected.The field hygienic investigation,field detection(air speed,temperature,humidity)and retrospective cohort study were carried out.Throat swabs were collected to detect M.pneumoniae DNA.Results A total of 52 M.pneumoniae pneumonia cases were identified,and the attack rate was 4.80%.The main clinical manifestations were cough(98.08%)and fever(92.31%).The epidemic curve showed a value-added pattern,and the outbreak lasted 73 days.The first case occurred on April 16,2023.The cases gathered in the 2~(nd)floor and in the building A.Field detection displayed that the air speed of building A was significantly lower than that of building B(0.06±0.05 m/s vs.0.12±0.09 m/s;t=-2.219,P=0.041).The differences in the air speed were significant(F=4.030,P=0.033)among different floors,the ventilation of the 2~(nd)floor was the worst.Poor ventilation layout was fund in building A and the 2~(nd)floor.Retrospective cohort studies suggested that chess game was the risk factor(relative risk=4.00,95%confidence interval:1.08-14.82).In the 38 throat swabs,8 were positive in the DNA detection of M.pneumoniae.The outbreak was effectively controlled after two closed-loop responses(risk analysis+proposed measures+tracking).Conclusion This was an outbreak of M.pneumoniae pneumonia,which might be transmitted by droplets.It is suggested to carry out risk assessment,conduct timely case reporting and isolation and strengthen ventilation and personal protection.

关 键 词：肺炎 支原体 队列研究 通风 疾病暴发流行 现场流行病学 

分 类 号：R211[医药卫生—中医学] R183.3