甘肃省首起新型冠状病毒肺炎家庭聚集性疫情分析

Analysis of the first cluster of cases in a family of COVID-19 in Gansu Province

分析甘肃省首起新型冠状病毒肺炎(COVID-19)家族聚集性疫情中7例COVID-19患者及1例密切接触者的流行病学史及临床特征。首例患者A于2020年1月22日发病,有武汉居留史,1月24日确诊COVID-19重症病例;患者B,2020年1月23日发病,1月31日确诊,重症病例;患者C无症状,1月27日确诊;患者D无症状,1月27日确诊;患者E,1月24日发病,1月28日确诊;患者F无症状,1月31日确诊;患者G无症状,1月31日确诊;密切接触者H无症状,PCR连续检测阴性,无症状,提前出院。7例患者中,1例(B)加重死亡,其他患者经过积极救治,病情均得到有效控制。除了出院病例外,有5例COVID-19特异IgM抗体检测阳性,1例检测阴性。此次聚集性暴发,4例患者始终无症状,但PCR和IgM抗体检测阳性,说明无症状者可能是此次控制疫情的关键节点,对于咽拭子核酸检测阴性但明确有毛玻璃样肺部病变的患者进行特异性IgM抗体筛查对病例早发现早隔离至关重要。

The epidemiological history and clinical characteristics of 7 cases of COVID-19 and 1 case of close contact in the first family aggregation epidemic of COVID-19 in Gansu Province were analyzed.The first patient A developed on January 22,2020,with a history of residence in Wuhan,and confirmed severe cases of NCP on January 24,2020;patient B,on January 23,2020,diagnosed on January 31,severe cases;patient C,asymptomatic,diagnosed on January 27;patient D,asymptomatic,diagnosed on January 27;patient E,on January 24,diagnosed on January 28;patient F,asymptomatic,diagnosed on January 31;Patient G was asymptomatic and was diagnosed on January 31.In close contact,H was asymptomatic,PCR test was negative and asymptomatic,and he was discharged early.Among the 7 patients,1 case died of(B)aggravation,and the other patients′condition was effectively controlled after active treatment.Except for the discharged cases,5 cases were positive for COVID-19 specific IgM antibody and 1 case was negative.In this clustering outbreak,4 patients remained asymptomatic,but PCR and IgM antibodies were positive,indicating that asymptomatic patients may be the key point to control the epidemic.Specific IgM antibody screening for patients whose pharyngeal swab nucleic acid test is negative but with ground glass-like lung lesions is very important for early detection and early isolation.