北京市房山区某小学一起聚集性不明原因肺炎疫情调查处置

Investigation and disposal of a pneumonia cluster epidemic of unknown etiology in a primary school in Fangshan District of Beijing

目的 对一起聚集性不明原因肺炎疫情的调查和处置进行总结,为今后支原体肺炎聚集性疫情的防治和处置提供经验和借鉴。方法 按照统一的病例诊断标准开展现场流行病学调查,并对采集的标本进行实验室检测。结果 北京市房山区某小学聚集性不明原因肺炎疫情共有26例病例,均为学生,明确诊断为肺炎患者19例。首发病例2018年5月26日发病,末例病例6月21日发病,病例主要集中在5月29日—6月2日,疫情共持续27天,累及2个相邻班级,罹患率为31.33%(26/83);其中1班病例数最多,为21例,罹患率50.00%(21/42)。临床症状以发热、咳嗽为主。男女生发病差异无统计学意义(P>0.05)。采集病例咽拭子标本12份,肺炎支原体核酸检测阳性7份,阳性率58.33%,采集痰标本3份,肺炎支原体核酸检测阳性3份,阳性率100%。病原体为支原体P1-Ⅰ型,对阿奇霉素耐药。结论 呼吸道多病原检测结果结合病例流行病学和临床表现,初步判定为一起由肺炎支原体引起的聚集性肺炎疫情。

[Objective]To summarize the investigation and disposal of a pneumonia cluster epidemic of unknown etiology,provide experience and reference for prevention and treatment of mycoplasma pneumonia cluster epidemic in the future.[Methods]Field epidemiological survey was conducted by unified diagnostic cases criteria,and samples were collected for laboratory tests.[Results]There were 26 cases in the pneumonia cluster epidemic of unknown etiology in a primary school in Fangshan District of Beijing,all of them were student,and 19 cases were definitely diagnosed as pneumonia. The first case occurred on 26 May2018 and the last case on 21 June 2018. The cases were mainly concentrated from May 29 to June 2. The epidemic lasted27 days and affected two adjacent classes,while Class One had the highest number of cases,with an incidence rate of 50.00%(21/42). The most frequent clinical symptoms were fever and cough. There was statistically significant difference in attack rate between gender groups(P>0.05). Among 12 throat swab samples,there were seven positive samples for Mycoplasma pneumoniae,with the positive rate of 58.33%. among three sputum samples,all were positive samples for Mycoplasma pneumoniae,with the positive rate of 100%. The pathogen was mycoplasma P1-Ⅰ,and resistant to azithromycin.[Conclusion]Combined with clinical symptoms,epidemic evidence and respiratory tract multiple pathogen detection results,this is initially identified as pneumonia cluster epidemic caused by Mycoplasma pneumoniae.