一起肺结核病聚集性疫情的流行病学调查

Epidemiological survey of a clustering infection of pulmonary tuberculosis

目的探讨某院校学员队一起肺结核病聚集流行的影响因素，为控制肺结核病疫情提供科学依据。方法对该院校发病学员队进行流行病学调查、x线检查、结核菌素试验，X线检查异常者进行痰结核分枝杆菌检查，确诊结核患者，追踪传染源。结果2011年10月初--2011年12月15日2个月多内，该院校某学员队80名学员中，共确诊肺结核病例9例，罹患率为11．25％。80例密切接触者中PPD检测，阳性人数62人，阳性率为77．50％；强阳性人数14人，强阳性率17．50％，高于对照的未发病学员队（P〈0．01）。结论首发病例的误诊与延误诊断，密切接触者预防措施不及时是本次肺结核聚集流行的源头。加强基层部队与卫生防疫部门之间的协作，采取综合性的肺结核病防控措施，预防肺结核病的聚集流行。

Objective To survey the factors relating to clustering infection of pulmonary tuberculosis （TB） among the recruits in a military school. Methods Epidemiological survey, X-ray check PPD test of the recruits were carried out and those with suspected X-ray results were further detected for the presence of Myeobacterium tuberculosis. Then the source of infection of tuberculosis was traced. Results During October 2011 to December 2011, nine pulmonary TB cases were detected among the 80 students with an infection rate of 11.25%. Sixty-two students were positive by PPD test with a positive rate of 77.50% and strong positives were observed in 14 students with a strong positive rate of 17.50 %, significantly higher than those without infection （P〈0.01）. Conclusion Misdiagnosis, diagnosis delay and without timely treatment and isolation of the initial TB ease were the main factors resulting in clustering infection of TB. TB control work in army should be strengthened by enhancement of comprehensive measures be taken to prevent the clustering infection of tuberculosis.