一起利福平耐药肺结核聚集性疫情的流行病学调查

Epidemiological investigation of a cluster of rifampicin-resistant pulmonary tuberculosis

2023年11月,金华市疾病预防控制中心接到报告,发现金华市某公司3例肺结核病例,立即组织人员对病例及其密切接触者开展现场流行病学调查。本起疫情共发现3例肺结核病例,罹患率为9.68%。首例病例咳嗽咳痰1年余,于2023年11月16日诊断为利福平耐药肺结核,另2例为其同事,分别于11月20日和21日诊断为利福平耐药肺结核和病原学阴性肺结核。根据流行病学调查和实验室检测结果,判断这是一起利福平耐药肺结核聚集性疫情。首例病例未及时就医,通过接触传播导致其他同事感染可能是疫情发生的主要原因。密切接触者筛查发现结核分枝杆菌纯蛋白衍生物皮肤试验阳性或重组结核杆菌融合蛋白皮肤试验阳性8人,给予预防性微卡注射治疗,3个月后随访未发现新发肺结核病例。本起疫情提示该公司应加强肺结核防治健康教育,开展日常性健康监测,完善员工体检制度,提高肺结核发现敏感性。

In November 2023,the Jinhua Center for Disease Control and Prevention received a report from a company indicating 3 cases of pulmonary tuberculosis.An on-site epidemiological investigation was immediately conducted.A total of 3 cases were reported,with an attack rate of 9.68%.The first case had cough and expectoration for more than a year,and diagnosed with rifampicin-resistant pulmonary tuberculosis on November 16,2023,and the other 2 cases were his colleagues who were diagnosed with rifampicin-resistant pulmonary tuberculosis and etiology negative pulmonary tuberculosis on November 20 and 21,respectively.Based on the on-site investigation and laboratory test results,it was a cluster of rifampicin-resistant pulmonary tuberculosis.The likely cause of the spread might be the lack of timely medical attention for the first case,which led to the infection of other colleagues through contact transmission.Eight close contacts screened positive for purified protein derivative(PDD)or recombinantMycobacterium tuberculosisfusion protein skin test(EC-ST),given the injection of mycobaeterium vaccae vaccine,and no new cases of tuberculosis detected in the 3-month follow-up.The outbreak highlighted the necessity for the company to enhance health education concerning the prevention and treatment of pulmonary tuberculosis,implement regular health monitoring and enhance the physical examination for employee in order to increase sensitivity to pulmonary tuberculosis.