某区SARS家庭聚集性病例的流行病学分析

EPIDEMIOLOGICAL ANALYSIS ON THE FAMILY-CLUSTERED SARS CASES IN CHAOYANG DISTRICT.

目的 :分析北京市朝阳区传染性非典型肺炎 (SARS)家庭聚集性病例的流行病学特征及临床表现 ,探讨家庭因素在 SARS传播中的作用 ,为有效控制该病的流行提供对策与依据。方法 :采用描述性分析方法对朝阳区 SARS家庭聚集性病例进行分析。结果 :朝阳区共发生家庭聚集性病例 175例 ,涉及 4 6户家庭 (族 ) ,死亡 32例 ,病死率 18.2 9%。家庭聚集性病例发病高峰在 4月中、下旬 ,病例数分别为 5 2例和 4 8例 ,占 5 7.14 %。男女发病性别比为 1∶ 1.30。发病年龄主要集中在 30～4 9岁年龄组 ,共 83例 ,占 4 7.4 2 %。死亡者以 5 0岁以上组居多 ,占死亡总数的 71.88% ,病死率随年龄的升高而上升 ,各年龄组之间病死率差异有显著性。家庭聚集性发病以楼梓庄乡、八里庄、左家庄和金盏乡较多 ,共计发生 5 2例 ,占 2 9.71%。其中 19户家庭 (族 )发生 2例病例 ,2 7户家庭 (族 )发生 2例以上 ,最多有 2户发生病例 11例。 31例首发病例发病前 2周有明确接触史 ,包括与 SARS病人接触 7例 ,因其他病在医院就诊、住院 16例及到医院探视 8例。家庭首发病例与二代病例发病时间间隔为 7d(中位数 )。结论 :控制

Objective:To analysis epidemiological characteristics of the family-clustered Severe Acute Respiratory Syndrome (SARS) cases in Chaoyang district,Beijing.And to reveal the determinants on the disease transmission.Methods:The family-clustered SARS cases were investigated with the standardized questionnaire followed a descriptive analysis.Results:A total of 175 family-clustered SARS cases with 46 families involved.The fatality rate was 18.29%.About 57.14% of the cases occurred in the middle and the last ten days of April.The ratio of sex was 1∶1.30.About 47.42% of the cases aged 30~49 and 71.88% of the dead case aged 50 years and above.The fatality rate was increasing along with the age and it was showed significantly different in the age groups.There were 2 cases in 19 families,more than 2 cases in 27 families,especially 11 cases in 2 families.The first cases about 31 of the involved families had apparent or suspect exposure.The median of the time interval between the first cases and the secondary cases was 7 days.Conclusion:The family-clustered SARS cases mainly occurred in the middle and the last ten days of April.The fatality and secondary attack rate was decreasing with the transmitted generations.Health care worker nosocomial infection control is a critical point in the epidemic control.