山东省寿光市一起学校肺结核聚集性疫情调查分析

Investigation and analysis on a school tuberculosis epidemic,Shouguang city,Shandong province

目的对山东省寿光市一起学校聚集性肺结核疫情进行调查分析,为探讨学校聚集性传染病疫情的防制策略提供参考。方法采用描述性流行病学方法,对2019年山东省潍坊市某学院一起学校聚集性结核病疫情进行调查,采用肺结核疑似症状筛查、结核菌素皮肤试验、肺部X光片检查等方法开展结核病重点人群筛查和现场流行病学调查,并筛查密切接触者。结果2019年1月在潍坊市某学院校内发现结核病首发病例后,先后通过三次密切接触者筛查,至2019年4月共发现有流行病学关联的病例10例,检出潜伏感染者103例。对确诊病例全部收治入定点医院治疗和休学,对潜伏感染者进行预防性服药,对其余密切接触者进行疑似症状监测等。通过一系列处置措施,该起聚集性疫情得到有效控制,自最后1例病例发现起3个月内未有续发病例,疫情发生后3年来该学校未再发生聚集性疫情,散发疫情数量也逐年减少。结论该起学校聚集性结核病疫情发生的根本原因是入学体检项目不全与首发病例就诊延迟,学校应提高对结核病的重视和对学生的健康监测。

Objective To investigate and analyze a cluster of tuberculosis in a school,so as to provide reference for the prevention and control strategies of cluster infectious diseases in schools.Methods Descriptive epidemiological methods were used to investigate the cluster of tuberculosis in a college in 2019.Screening of tuberculosis suspected symptoms,tuberculin skin test,lung X-ray and other methods were used to carry out tuberculosis screening and field epidemiological investigation,and screening of close contacts.Results After the first case of tuberculosis was found in the campus of a college in January 2019,10 cases of epidemiologically associated cases and 103 cases of latent infection were detected through three rounds of close contact screening.All confirmed cases were admitted to designated hospitals for treatment and suspended from school,latent infected people were given prophylactic medication,and other close contacts were monitored for suspected symptoms.Through a series of measures,the cluster epidemic was effectively controlled.No further cases occurred within 3 months after the last case was found.No cluster epidemic occurred in the school for 3 years after the outbreak,and the number of sporadic outbreaks also decreased year by year.Conclusion The root cause of the cluster tuberculosis outbreak in this school is incomplete physical examination and delayed diagnosis of the first case.Schools should pay more attention to tuberculosis and monitor the health of students.