某小学一起腺病毒急性呼吸道感染暴发现场调查

Field epidemiology investigation of a human adenovirus outbreak with acute respiratory infection in a primary school

目的:调查中山市某小学一起腺病毒呼吸道感染暴发疫情传播特征及危险因素。方法:制订病例定义,开展病例搜索;并针对病例发病情况及相关因素开展现场流行病学调查。结果:共搜索到32例病例,其中11例为实验室诊断病例。病例分布在1个班,年龄8~9岁,罹患率62.7%。临床主要症状有发热(100%)、咽痛(62.5%)、咳嗽(59.4%)、头痛(31.3%)、呕吐(28.1%)、流涕(25.0%)。首发病例2019年5月20日发病,20、21日带病上课,期间天气炎热潮湿,教室紧闭门窗,采用空调降温。结合潜伏期和学校放假日期,推测二代病例22例,三代病例9例。结论:首发病例未及时隔离和教室通风不良,可能是导致本次疫情传播的主要危险因素。

Objective: Investigation of the transmission characteristics and risk factors of a human adenovirus outbreak with acute respiratory infection in a primary school of Zhongshan city. Methods: Case definition was carrying out for searching cases. Field epidemiology investigation was taken for information of pathogenesis and risk factors of cases. Results: 32 cases were found including 11 exact cases who were verified that adenovirus nucleic was positive by PCR tests. All cases were 8 to 9 years old and clustered in the same classroom so that the attack rate of this outbreak was 62. 7%. The mainly clinical symptoms included fever( 100%),pharyngalgia( 62. 5%),cough( 59.4%),headache( 31.3%),vomit( 28. 1%) and rhinorrhea( 25. 0%). The index case was attacked on May20,2019,and went to school on the 20 th and 21 st. During this periond,the weather was hot and humid. The doors and windows of the classroom were closed and airconditioning was used to cool down. It was inferred that 22 secondary cases and 9 third generation cases were occurred referring to potential days of adenovirus and holidays.Conclusion: Without isolation of the index case in time and poor classroom ventilation may be the main risk factors for the spread of this epidemic.