某中学一起肺炎支原体感染暴发调查

Investigation of an Outbreak of Mycoplasma pneumoniae Infection in a Middle School

目的分析深圳市宝安区某中学一起肺炎支原体感染（ARID）暴发的三间分布,探讨主要危险因素。方法用描述流行病学方法分析该起暴发的三间分布;用病例对照研究方法探讨该起暴发的主要危险因素。结果 2010年3月2日-6月10日,某中学发生肺炎支原体感染536例（38例病人标本实验室检测肺炎支原体阳性）。罹患率学生为13.98%,教职工为0.30%;学生中男性罹患率（15.93%）高于女性（12.04%）（χ2=12.07,P〈0.05）;新疆生罹患率（27.83%）高于本地生（9.60%）（χ2=193.1,P〈0.05）,高中罹患率（19.13%）高于初中（9.40%）（χ2=75.11,P〈0.05）。初中三年级教学楼三楼班级分布的正态偏差值（ND）为2.30（P〈0.05）,三栋五楼宿舍分布的ND为4.45（P〈0.05）,分布均有聚集性。病例对照研究显示,＂接触呼吸道感染者＂（OR=3.9,95%CI=1.4~11）和＂经常咬笔头玩具＂（OR=6.1,95%CI=1.1~44）是危险因素。结论本次急性呼吸道感染为一起肺炎支原体感染暴发,传播方式以飞沫传播为主。建议加强学生个人卫生和防护意识的健康教育。

Objective To analyze the three-dimension distribution of an outbreak of Mycoplasma pneumoniae infection in a middle school of Baoan District of Shenzhen City and discuss the major risk factors.Methods The distribution of the outbreak was analyzed by descriptive epidemiologic study and the main risk factors were explored by case-control study.Results Totally,536 patients were infected with Mycoplasma pneumoniae in the middle school from March 2 to June 10,2010,including 38 cases with specimens of positive laboratory detection results.The attack rate in the students was 13.98%,and that in the faculty was 0.30%.The attack rate（15.93%） was significantly higher in the male students than in the females（12.04%,χ2=12.07,P0.05）,higher in the students from Xinjiang（27.83%） than in the native students（9.60%,χ2=193.1,P0.05）,and higher in the high school students（19.13%） than in the junior middle school students（9.40%,χ2=75.11,P0.05）.The normal deviate values（abbreviated ND） of the class distribution on the third floor of teaching building of grade Ⅲ of junior middle school and of the dormitory distribution on the fifth floor of the third building were 2.30（P0.05）and 4.45（P0.05）,respectively,indicating the aggregation of the distribution.The case-control study illustrated that contacting with patients with respiratory tract infection（OR=3.9,95% CI=1.4-11） and often biting pens and toys（OR=6.1,95% CI=1.1-44） were the risk factors.Conclusions This acute respiratory tract infection was an outbreak of Mycoplasma pneumoniae infection,with droplet transmission as its major transmission route.Health education on students＇ personal hygiene and protection consciousness should be strengthened.