重症监护病房内一起疑似疥疮暴发的调查与防治

Investigation and prevention of a suspected scabies outbreak in the intensive care unit

目的 分析重症监护病房内一起疑似疥疮的流行规律、临床特征,为采取有效预防与控制措施提供科学依据. 方法 采取病例查阅和现场流行病学调查的方式,对疑似疥疮暴发的时间分布、空间分布及人群分布等特征进行分析. 结果 本次调查发现,2011年8月底至10月中旬在同一重症监护病房内发生3名患者和2名医务人员疑似感染了疥疮,5名医患人员皮疹部位及瘙痒特征相似,发病时间和地点集中,存在交叉感染的可能性.5名医患人员使用硫磺软膏全身涂搽2个疗程后,症状逐渐缓解或消失,治疗效果明显,并给予了疥疮相关知识的教育指导,使用药物治疗和采取消毒隔离等措施后暴发得到控制,再无新发病例. 结论 未能及时考虑感染疥疮的可能性是发生本次医院感染暴发的主要原因.医务人员要掌握疥疮发病的临床特点,早期识别并采取有效的消毒隔离措施,以防止医院感染暴发再次发生.

Objective To analyze the epidemic features and clinical characteristics of a scabies outbreak in the intensive care unit （ICU）, so as to provide basis for the prevention and control measures of the infec- tions. Methods The distributions by people, time and place of the suspected scabies were analyzed by de- scription of each cases and investigation of the epidemiological status of the exposure. Results The survey found, 3 patients and 2 medical staffs were suspected to have scabies infection during the end of August to mid October in 2011. The exposure may cause by cross-infection due to the concentrated time and place of the cases. Characteristics of the rash and the pruritus of the cases were similar and they were cured after 2 courses of sulfur ointment treatment. Training for all involved persons, effective treatment of the cases and measures of disinfection and isolation contributed to the successful termination of the outbreak. Conclusion Lack of rapid diagnoses and treatment is the main cause of this suspected scabies exposure. It is suggested that more careful observation, early detection and diagnosis, as well as effective disinfection and isolation measures are of great significance to prevent outbreaks to happen again.