澳門地區某醫院麻疹群聚感染事件分析及建議

Epidemic report and suggestion of measles cluster infection in a hospital in Macao region

目的探討澳門地區某醫院收治一名發熱、皮疹的男病人造成院内麻疹群聚感染事件的經過,為制定針對性的院内防控措施提供依據。方法採用描述流行病學方法對該院麻疹群聚感染資料進行分析。結果此事件造成8位醫療人員及6位門診求診者確診感染麻疹。分析主要原因是麻疹流行地區與澳門地區往來密切,造成澳門地區輸入性麻疹的風險增加。以及,澳門地區20歲~29歲已接種麻疹疫苗的居民,麻疹免疫力不足。結論完善中國澳門居民麻疹、腮腺炎、德國麻疹混合疫苗接種(Measles,Mumps and Rubella,MMR),特別是高風險科室工作的醫務人員。醫療機構出現麻疹確診個案,需要及時評估接觸者,為符合暴露後預防接種條件者即時應急接種MMR疫苗。對不典型麻疹病例應早期進行鼻咽拭子病原學檢測,及對醫療人員進行麻疹定義及處理的相關宣教,防止麻疹在院内或社區傳播。

Objective To explore the process of measles cluster infection caused by a male patient with fever and rash in a hospital in Macao region,and provide evidence for prevention and control strategies in the hospital.Methods Descriptive epidemiological method was used to analyze the data of measles cluster infection in the hospital.Results As a result of this incident,8 healthcare providers and 6 outpatients were diagnosed with measles.The main reason of analysis was that the measles epidemic areas had close contacts with Macao region,which leading to the increased risk of imported measles in Macao region.Macao region residents aged 20~29 who have been vaccinated against measles were insufficient for measles immunity.Conclusion Measles,Mumps and Rubella(MMR)vaccination should be improved for Macao region residents,especially for healthcare providers working in the high-risk departments.For the onset of confirmedmeaslescases in the hospital,it is necessary to evaluate measles contacts in timeand to provide the post-exposure MMRvaccination for those who meet the criteria in real time.The etiology of nasopharyngeal swab was suggested as to detectthe early atypical measles cases.In addition,healthcare providerswere recommended to be well educated on the definition and treatment of measles as to prevent measles from spreading in hospitals or communities.