上海市一起公共场所新型冠状病毒肺炎聚集性疫情流行病学调查

A cluster epidemic of COVID-19 related to exposure in a public setting inShanghai: survey report

目的对上海市一起发生在公共场所的新型冠状病毒肺炎(COVID-19)聚集性疫情回顾性流行病学调查,分析疫情的感染来源、传播方式和传播链。方法2020年1月—2月,对病例的基本情况、发病与诊疗、临床表现、发病前14天内暴露史和危险因素、密切接触者等信息现场流行病学调查,采集病例的呼吸道标本进行rRTPCR新型冠状病毒核酸检测,分析病例间的流行病学关联及聚集性疫情的传播链。结果该起聚集性疫情涉及4例确诊病例,其中3例曾在同一公共场所内活动。病例一2020年1月11日—16日至武汉出差,1月21日确诊;1月17日,病例一发病后至某客户服务中心,与病例二、病例三之间在未佩戴口罩和手套的情况下有多次接触;病例二1月28日发病,2月2日确诊;病例三1月21日发病,2月1日确诊;病例三的妻子病例四2月2日发病,2月4日确诊。与病例一的接触可能为病例二、病例三的感染来源,与病例三的共同生活可能为病例四的感染来源。结论COVID-19可通过在公共场所的接触而传播导致聚集性疫情,需关注室内公共场所可能的传播风险、加强针对性的防控措施。

Objective To analyze infection source,transmission mode and transmission chain of a cluster epidemic of coronavirus disease 2019(COVID-19)related to exposures in a public setting in Shanghai.Methods We conducted a retrospective survey on four COVID-19 cluster cases occurring from January to February 2020 in Shanghai.With interviews and field surveys,we collected information on the cases′demographics,illness onset,diagnosis,treatment,clinical manifestations,exposure history,potential risk exposures within 14 days before onset,and close contacts.Respiratory specimens of the cases were sampled for detecting nucleic acid of severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)by real-time reverse transcription PCR(rRT-PCR).Results Of the four laboratory confirmed cluster cases,three reported being attendees of a public setting(a customer service center)in the same day with a duration about 60–90 minutes.The first case–a 40 years old man developing symptoms of COVID-19 on January 17,2020 and being diagnosed as confirmed COVID-19 case 4 days later,reported a history of a business trip to Wuhan during January 11–16,2020 and multiple contacts with the second case and third case without wearing a mask and gloves with a social distance of 1–3 meters when being in the public setting as a customer.The second case was a 39 years old man working in the customer service center,who developed the symptoms on January 28 and was diagnosed 5 days later;the third case was a 75 years old male customer,who developed the symptoms on January 21 and was diagnosed 11 days later.The fourth case was the third case′wife,who developed the symptoms on February 2 and was diagnosed 2 days later.Based on the analysis on collected information,we considered that in this cluster epidemic,the infection of second and third case could possibly be attributed to their contacts in the pubic setting with the first case and that of fourth case to family contact with the third case.Conclusion COVID-19 can be transmitted through contacts in public settings,leading to clustering infection and targeted preventive measures need to be developed to control possible risk of transmission of the disease in public places.