一起肺炎支原体感染暴发疫情的流行病学调查分析

Epidemiological investigation and analysis of an outbreak caused by Mycoplasma pneumoniae

目的：调查分析某部发生的一起肺炎支原体感染暴发疫情的流行特征和防控效果，提出进一步防控建议。方法采用流行病学现况研究方法，对所有病例的基本特征、临床表现和聚集性活动等进行个案调查。根据血清学检查和流行病学调查结果判定肺炎支原体感染情况。结果在2013年5月16日至2013年6月11日期间，某部队共出现49名确诊病例和38名疑似病例，均为男性，总体罹患率为7．8％。疫情高峰时间段为5月27日至6月2日（7 d），病例总数66人（占75．9％）。在疫情暴发期间，学兵10队、其他学兵队和非学兵队人群的罹患率分别为47．5％、4．5％和1．2％，其差异具有统计学意义（P＜0．01）。49名确诊患者年龄为17～26岁，不同年龄组人群罹患率无统计学差异。患者籍贯和兵源地无明显聚集性。感染病例最常出现的临床症状为发热和咳嗽，62．5％确诊病例出现了单侧或双侧肺部炎性改变，肺部阳性体征少见。所有确诊病例均住院治疗，无重症或危重病例出现。在采取病例监测、隔离观察、取消密集性活动、分散居住以及预防性服用阿奇霉素等防控措施之后，疫情得到有效控制。结论封闭、密集的学习和训练部队易出现肺炎支原体感染暴发，有必要进一步提高防病意识，加强病例管理，尽量分散居住，减少密集活动，落实个人卫生制度。

Objective To investigate the epidemiological characterization , effect of prevention and control measures during an outbreak in a military unit caused by Mycoplasma pneumoniae.Methods All the cases were investigated to learn about their basic characteristics , clinical symptoms and aggregation activities using epidemiological cross-sectional study . Results From May 16 to June 11,2013, forty-nine confirmed cases and thirty-five suspected cases who were all males were found at an attack rate of 7.8%.The epidemic peak period was from May 27 to Jun 2（seven days）, and the number of total cases was 66（75.9%）.During the outbreak, the attack rate of the 10th cadet team, other cadet teams and a non-student population was 47.5%, 4.5% and 1.2% respectively.The difference was significant （P＆lt;0.01）.The age of forty-nine confirmed cases ranged from 17 to 26 years old , the attack rate did not differ significantly between different age groups, and no aggregation was found in the place of birth and soldier source .The most frequent clinical symptoms were fever and cough for the confirmed cases , 62.5% of whom showed unilateral or bilateral lung inflammation change , while few positive lung symptoms were present .All the confirmed cases were hospitalized and no severe or critically ill cases were present.The outbreak was controlled effectively after implementation of case surveillance , contact precaution , termination of aggregation activities , dispersed habitation and prescription of azithromycin for disease prevention .Conclusion The confined and crowed environment for learning and training can increase the risk of M.pneumoniae outbreak , making it nec-essary to enhance disease prevention awareness , improve case management , live dispersed , reduce close contact and imple-ment personal hygienic measures .