中小学流感暴发疫情病例居家隔离治疗对家庭传播影响分析

Household transmission and risk factors of home quarantine treatment after school-based influenza outbreak

目的研究中小学校流感暴发后的家庭引入病例导致家庭内传播的继发感染率和影响因素,为制订家庭传播控制策略提供科学依据。方法调查常州市2014年5月—2015年1月10起中小学校流感暴发事件中的发病学生及其家庭成员,探讨家庭继发感染状况,评估家庭传播的影响因素。结果 1 075例家庭接触者中报告流感样症状175例,继发感染率为16.28%（95%CI=14.19%~18.61%）,代间距中位数为3 d,集体宿舍和人均居住面积≤20 m2是家庭传播的危险因素（RR值分别为1.90,1.78）,每天开窗通风可以减少家庭感染（RR=0.63）。结论学校流感暴发疫情处置＂居家隔离治疗＂措施,易发生流感病例家庭内传播继发感染,应加强家庭病例和密切接触者的卫生管理。

Objective To identify secondary attack rate and factors associated with household transmission of intluenza alter school outbreaks, as well as to provide scientific basis for control strategy. Methods From May 2014 to Jan 2015, investigations were conducted among student patients and their household contacts in 10 school influenza outbreaks to identify secondary infection, and assess the household transmission risk factors. Results A total of 175 influenza-like illness was reported of 1 075 household contacts. The secondary attack rate was 16.28% （95%CI： 14.19%-18.61% ） and the serial interval was 3 days. The risk of household transmission was higher with living in dormitory or living area ≤20m^2 per person, and lower with ventilating window everyday. Conclusion ＂Home quarantine treatment＂ measures after school influenza outbreak lead to family spread and secondary infection. Health management should be enhanced for household cases and close contacts.