天津市传染性非典型肺炎流行特点及主要控制措施效果评价  

Epidemiological characteristics of severe acute respiratory syndrome in Tianjin and the assessment of effectiveness on measures of control

作　　者：王撷秀[1] 冯洪友[1] 刘东[1] 张之伦[1] 单爱兰[1] 朱向军[1] 高志刚[1] 王栩冬[1] 夏英毅[1] 陈茜[1] 

机构地区：[1]天津市卫生防病中心,300011

出　　处：《中华流行病学杂志》2003年第7期565-569,共5页Chinese Journal of Epidemiology

摘　　要：目的　分析天津市传染性非典型肺炎 [严重急性呼吸综合征 (SARS) ]流行病学特征 ,对主要控制措施的效果进行初步评价。方法　采用自行设计的病例报告表 ,全市统一的流行病学个案调查表及病例接触者、密切接触者树状分布图 ,深入病房、家庭、社区、团体等对病例及接触者进行调查。结果　以发病时间计算 ,自 2 0 0 3年 4月 1 3日至 5月 8日 ,包括输入病例在内发病 1 75例 ,发病率为 1 .9 1 0万 ,其中死亡 1 4例 ,病死率达 8.0 %。整个流行过程不足 1个月 ,流行特点 :1例“超级传播者”直接或间接传染了全市 94.3 %的病例 ;呈现以A、B、C 3家医院聚集发病为特点的爆发性流行 ,占全市病例的 68.6 % ,3家医院外的家庭聚集发病占全市病例的 1 4 .3 % ,同事间传播为 2 .3 % ,散发者为 9.1 % ,这些散发者未造成接触者感染 ;早期医务人员发病较多 ,占总病例数的 38.2 % ,流行全过程参加SARS救治工作的 1 975名医护人员的总感染率为 3 .4 % ;全部流行过程传染源明确 ,传染链清晰 ,全市仅 3例患者未找到传染源 ,占病例总数的 2 % ;在 1 0例源头病例中仅“超级传播者”和另一病例传染了其接触者 ,其他传染源由于及时隔离未造成任何传播。结论　SARS是严重急性呼吸系统传染病 ,如能及时准确地掌握传染链并进行范围适?Objective To analyze the epidemiologic characteristics of severe acute respiratory syndrome (SARS) and to evaluate the effectiveness on its major control measures in Tianjn. Methods Adopting two case reports 1 and 2, designed by the Tianjin Centers for Disease Control and Prevention to develop a unified case tracing table including the map of the distribution of close contacts to SARS patients. With those methods, investigation on patients and their close contacts at hospital wards, families, communities and institutions of the patients were carried out. Results From April 13 through May 8, 2003, there were 175 SARS cases including imported ones, were identified with an incidence rate of 1.9 cases per 100 000 . Among them, 14 died with a fatality of 8.0 %. The whole process of epidemic in Tianjin was less than one month with the following features: (1) 93.7 % of the total SARS cases in Tianjin were directly or indirectly transmitted by a super spreader. (2) 68.6 % of the total SARS patients were concentrated in 3 hospitals A,B and C which was menifastated in ‘clustering’. Through study on the rest of the SARS patients, results showed that 16.8 % of them were tramsmitted through family close contact and 2.3 % due to contact to colleagues. However, 12.6 % of the patients were not able to show evidence that they had any contact to a diagnosed SARS patient. At the early stage of the epidemic, a number of medical practioners were infected, taking up 38.2 % of the total SARS cases. Among the total number of 1 975 medical workers who participated in the SARS medical cares and treatments, 3.4 % of them got infected. During the outbreak, all index cases and chains of transmission seemed to be clear, with only 3 patients not able to be traced for the source of infection, taking up 2% of the total SARS patients in Tianjin. Among the 10 index cases, only the super spreader and another one index case transmitted the virus to their contacts but the rest of index cases did not cause any

关 键 词：天津市 传染性非典型肺炎 流行特点 控制措施 效果评价 流行病学 

分 类 号：R181.3[医药卫生—流行病学]