一起疑似军团菌病暴发的调查和病原学分析

Analysis of aetiological and investigation of suspected outbreak legionnaires' disease

目的查明疫情暴发的病原、传染来源、传播途径和相关危险因素,为有效防控疫情提供科学依据。方法采用现场流行病学调查和实验室检测相结合的方法对病例进行个案调查,并分别采集血清标本、咽拭子、痰标本、尿标本及外环境样本进行检测。结果某工厂两天内累计出现27例病例,发病时间集中在3月4日13：00-17：00;年龄最大39岁、最小18岁,平均24岁。全部是PCBA车间职工,同楼层其他车间工作人员未发现类似症状病例,PCBA车间职工罹患率为33%。实验室检测6份血液标本检出金黄色葡萄球菌,未检出嗜肺军团菌。结论根据病例的潜伏期、临床症状、诊疗方式、病程,推断为一起车间内庞蒂亚克热暴发疫情,由军团菌感染引起。

Objective To identify the pathogen,the source of infection,mode of transmission and risk factors for the outbreak,and provide a scientific basis for the disease control. Methods Field investigation、 and laboratory test were implemented,Blood samples,throat swabs,sputum samples,urine specimens and environmental samples are collected. Results 27 cases appeared in 2 days,the onset time centered in march 4th 13： 00 - 17： 00,the oldest was 39 years,the youngest was 18 years,with an average of 24 years. They were all PCBA workshop workers,and the other workshop with floor staff were not found similar symptoms case. The attack rate of PCBA workshop was 33%. Staphylococcus aureus was detected in 6 blood samples,Legionella pneumophila is not detected in all samples. Conclusion According to the patient ＇s incubation period,clinical symptoms,diagnosis and treatment mode and duration. This incident can be defined as an outbreak of suspected legionnaires＇ disease in a workshop,the pathogen is the legionella.