2009年天津市甲型H1N1流感学校暴发疫情及处置对策分析

Epidemic and control of pandemic influenza A (H1N1) in Tianjin municipality,2009

目的分析和评价天津市2009年甲型H1N1流感暴发流行特征及控制措施效果。方法选取天津市2009年甲型H1N1流感社区广泛传播阶段的暴发,评价现场处置时间及停课等措施对控制疫情的影响。结果共报告流感样病例1498例,平均罹患率为2.12%。首发病例发病至报告疫情时间中位数为5 d,疫情流行时间中位数为12.5 d。首次现场处置时罹患率中位数为1.17%,处置后暴发持续时间中位数为6 d。首次现场处理时学校罹患率与总罹患率呈正相关(r=0.77,P=0.000)。在学校罹患率≤1%时处置疫情,总罹患率低于当罹患率>1%报告时的总罹患率(P=0.000)。罹患率≤1%时停课总罹患率与罹患率>1%停课的总罹患率差异无统计学意义。结论学校早期及时报告暴发疫情是有效控制甲型H1N1流感暴发的关键;在甲型H1N1流感社区广泛传播阶段,流感暴发时需做好隔离病例,开窗通风等综合的防控措施。

Objective To analyze the epidemiological characteristics of pandemic influenza A（H1N1） epidemic and evaluate the control measures in Tianjin in 2009.Methods The control effects of field response time and school closure were evaluated for 18 influenza A（H1N1） outbreaks in the communities in Tianjin.Results A total of 1498 influenza like illness cases were reported,the average attack rate was 2.12%.The median of the intervals between the onset of the first case and reporting was 5 days.The median of the outbreak durations was 12.5 days.The median of the attack rates at the first field response was 1.17%.The median of the outbreak durations after response was 6 days.The attack rate at the first response were positively correlated with the overall attack rate（r=0.77,P=0.000）.If the response was taken when the attack rate in schools was ≤ 0.1%,the overall attack rate was lower than that when the attack rate in schools was 0.1%（P=0.000）.The difference on the overall attack rate had no statistical significance when the school closure was taken if the attack rate was ≤ 0.1% or 0.1%.Conclusion Early reporting of the outbreak in school is the key to control pandemic influenza A（H1N1）.When pandemic influenza A（H1N1） widely affects communities,it is necessary to take comprehensive control measures,such as case isolation and room ventilation.