174例轻型急性呼吸道感染症流行病学调查分析

Epidemiological Survey on 174 Cases of Mild Acute Respiratory Infection

目的 分析东台市一起轻型急性呼吸道感染症疫情的临床特点和流行过程 ,为疾控工作提供科学依据。方法 选取许河、三仓两镇 174名轻型急性呼吸道感染症住院病人 ,对病人的基本情况、临床表现、治疗转归和接触史等方面展开流行病学调查 ,并汇总分析。结果 (1)疫情集中在 5、6月份 ,病例主要分布于镇区中小学及幼儿园。 (2 )临床特点有发热、咽痛、扁桃体肿大 ,肺纹理增强 ,白细胞升高以中性粒细胞升高为主。 (3)对病人咽拭子和血样等进行病原学检测 ,结果表明腺病毒 (3型 )感染是本病的主要原因。阿奇霉素、头孢呋新和病毒唑等药物治疗效果较好。(4)大多数病人发病前有类似病人的接触史 ,平均潜伏期 4～ 5d。结论 此类轻型急性呼吸道感染症传染性强 ,传播速度快 ,但病原体毒力较弱 ,症状较轻。加强疫情监测、早期发现病人 ,减少同学之间的相互接触、注重饮食和环境卫生 ,加强个人卫生和防护等 ,是控制本病传播的主要措施。

Objective The present investigation was intended to explore the clinical characteristics and epidemic process of mild acute respiratory infection in the city of Dongtai in order to provide a scientific basis for the prevention of spread of the disease. Methods 174 cases of hospitalized patients with mild acute respiratory infection in the towns of Xuhe and Sancang were selected and epidemiological investigation was carried out in terms of basic condition, clinical manifestation, therapeutic turnover and contact history of patients, followed by summary analysis. Results(1) The epidemic occurred mainly in May and June with cases principally distributed among primary and middle schools and kindergartens in towns and districts. (2) Clinical characteristics included fever, pharyngalgia, swelling of tonsil, increased lung marking and increase in leucocytes and neutrophils. (3)Pharyngeal swabs and blood samples were obtained from patients for etiological tests, conducted by Jiangsu CDC, Fudan University and China CDC, and it was showed that adenovirus (Type III) infection was the main cause of this disease. Drugs such as Azithromycin, Cefuroxime and virazole showed better therapeutic efficacy. (4)Most patients had a contact history of other patients with a similar disease before onset, with an average latent period of 4-5 days. Conclusion Mild acute respiratory infection is highly infective and has a quick transmission, but the virulence of pathogens is relatively weak and hence symptoms are not serious. The reinforcement of epidemic monitoring, early detection of patients, reduction of contact between classmates, promotion of food, drinking water and environmental hygiene, as well as enhancement of individual sanitation and prevention are major interventions to control transmission of the disease.