西藏那曲市某小学一起肺结核疫情调查(2021年)

An outbreak of pulmonary tuberculosis in a primary school in Naqu city, Tibet, 2021

目的了解西藏那曲市一起小学肺结核聚集性疫情,发现学校结核病防控中存在的问题。方法对那曲市X小学从2021年1月1日至8月30日期间按照《国家肺结核诊断标准》(WS288-2017)所确诊的病例展开调查。采用描述性流行病学方法对该起疫情进行调查。结果首发病例3月3日出现临床症状,3月10日开学后带病上课,直至4月2日到市级医院就诊后确诊,学校5月12日至6月30日放假筛查中断,至8月4日确诊最后一例病例。本次疫情共发现肺结核病例73例,临床诊断病例65例,确诊病例8例,均为学生,罹患率为2.60%(73/2803)。其中潜隐期感染者15例,潜隐期感染率为0.54%(15/2803)。首发病例所在的六年级11班罹患率最高,为37.14%(13/35)。结论本起疫情是一起学校肺结核聚集性疫情,发生原因为首发病例发现不及时。疫情处置中未能及时将风险人群全面筛查,导致疫情持续时间较长。

Objective To investigate an outbreak of pulmonary tuberculosis(TB)in a primary school in Naqu city,Tibet,so as to identify the problem on TB prevention and control in the school.Methods The investigation was conducted on the cases confirmed in accordance with the National Tuberculosis Diagnostic Standards(WS288-2017)in X primary school of Naqu city from January 1 to August 30,2021.Descriptive epidemiological method was used to analyze the epidemic situation.Results The first case had clinical symptoms on March 3,then attended class with illness on March 10.She was diagnosed in a municipal hospital on April 2.The school suspended the screening during the school holiday from May 12 to June 30.The last case was diagnosed on August 4.A total of 73 TB cases were found in this epidemic including 65 clinical cases and 8 confirmed cases.All cases were students,with an incidence rate of 2.60%(73/2803).There were 15 students of latent infection with the latent infection rate of 0.54%(15/2803).The incidence rate in Class 11 of Grade 6 where the primary case located was the highest of 37.14%(13/35).Conclusions This TB outbreak is a cluster in a primary school and is caused by delayed identification of the primary case.In addition,the risk population miss the comprehensive screening in time resulting in a long epidemic duration.