一起境外输入新型冠状病毒肺炎家庭聚集性疫情流行病学调查和诊疗分析

Investigation on an imported coronavirus disease 2019 family cluster outbreak

目的分析一起境外输入新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)家庭聚集性疫情的流行病学及临床表现特征,为做好输入性COVID-19诊疗和防控提供科学依据。方法在口岸检疫中发现自英国返回北京的2例COVID-19可疑病例,与同行其他4名家庭成员集中医学隔离,收集并分析该家庭成员基本情况、暴露史、临床表现、实验室检测、诊断治疗与转归情况等信息。结果本次家庭聚集性疫情共涉及6人,4例确诊病例,1例无症状感染者,1例未感染。感染来源为英国伦敦社区暴露。祖母发病最早且迅速发展为重症,儿子、儿媳及小孙女为普通型,孙儿为无症状感染者,大孙女未感染。该家系暴露后的发病时间平均为8 d,发病到确诊时间平均为6 d。结论该境外输入性家庭COVID-19疫情为家庭密切接触聚集性传播;病情与感染者年龄、自身免疫力等因素相关;加强入境健康申报、疑似病例和密切接触者筛查和集中隔离收治,预防境外输入性病例播散感染是目前我国预防COVID-19传播的关键。

Objective To study the epidemiological characteristics and clinical features of an imported COVID-19 family cluster epidemic,so as to provide scientific basis for the diagnosis,treatment and prevention of imported COVID-19.Methods Two suspected COVID-19 cases,returning from the UK to Beijing,were found in port quarantine.Subsequently,these suspected cases,along with four accompanying family members on the same flight,were underwent intensive medical isolation.In this study,the background information,exposure history,clinical manifestations,laboratory tests,diagnosis,treatment and clinical outcome of the family members were collected and analyzed.Results Totally,six people have been involved in the family cluster outbreak,with four confirmed cases,one asymptomatic and one uninfected.Among these six cases,the source of infection was exposure to the London community in the UK;the grandmother was the first one to get ill,and develop severe disease type;the son,daughter-in-law and little granddaughter developed the common disease type;the grandson was asymptomatic infected;the elder granddaughter was not infected.The average onset time after exposure was eight days,and the average time from onset to diagnosis was six days.Conclusions The imported covid-19 outbreak in this study was a family cluster transmission due to close family contacting,and the severity grade of the disease was related to patients’status,such as the age,immunity,etc.According to this study,the keys for preventing disseminated epidemic of imported COVID-19 cases in China should include strengthening the entry health declaration as well as centralized screening and isolation of suspected cases and close contacts.