天津市滨海新区某小学流感暴发疫情调查分析

Investigation and analysis of influenza outbreak in a primary school in Binhai New Area of Tianjin

目的流感病毒潜伏期短、传染性强及传播迅速,在集体单位或人群聚集场所易引起暴发流行,具有极强的危害性。为有效防控学校流感暴发疫情,本研究总结天津市滨海新区某小学流感样病例暴发疫情的发现、调查、分析和处置,了解流感暴发原因和规律,总结经验教训,为科学防控流感暴发疫情提供参考。方法根据《流感样病例暴发疫情处置指南(2012版)》,采用现场流行病学调查方法,对滨海新区某小学2017-11-15以后发现的流感样病例进行调查与处理,采集现症发热病例咽拭子标本,采用实时聚合酶链反应(real-time polymerase chain reaction,RT-PCR)方法检测流感病毒核酸。结果暴发累计病例人数为68例,教师无发病,罹患率为3.82%。病例分布在6个年级29个班,罹患率最高为6年级2班19.44%,占总发病人数的10.29%,发病有班级聚集性。男女比例为1.27∶1,年龄集中在7~9岁组。临床表现以发热(100.00%)、咳嗽(88.24%)和咽喉肿痛(80.88%)症状者居多。共采集患者咽拭子标本10份,送检做流感病毒核酸检测,结果2份为乙型流感病毒核酸阳性。各项措施落实后疫情得到有效控制,自2017-12-14后无续发病例。结论未及时隔离治疗患者和学校防控流感措施不到位是引起流感病毒暴发的原因。学校加强晨检、隔离患者、提高流感疫苗接种率、做好健康教育,是预防和控制学校流感暴发疫情的最有效措施。

OBJECTIVE Flu virus incubation period is short,infectivity is strong,transmission is rapid,in collective unit or the place that the crowd gathers easy cause outbreak epidemic,have extremely strong harm.Trough the discovery,investigation,analysis and disposal of the outbreak of influenza-like cases in a primary school in Binhai New Area of Tianjin,the study is to understand the causes and rules of influenza outbreak,summarize experience and lessons,and provide reference for scientific prevention and control of influenza outbreak in schools.METHODS According to the Guidelines for Handling Influenza-like Cases Outbreak(2012 edition),the influenza-like cases found in a primary school in Binhai New Area since November 15,2017 were investigated and treated by field epidemiological investigation.Pharyngeal swab samples of the cases with fever were collected and the nucleic acid of influenza virus was detected by Real-Time PCR.RESULTS The cumulative number of cases in this outbreak was 68.Teachers did not suffer from the outbreak.And the incidence rate was 3.82%.The cases were distributed in 29 classes of six grades.The highest incidence rate was in Classes 2 of Grade 6,accounting for 19.44%,accounting for 10.29%of the total number of cases.The ratio of male to female was 1.27∶1.The age group was 7-9 years old.The clinical manifestations were fever,cough and sore throat,accounting for 100.00%,88.24%and 80.88%,respectively.A total of 10 swab samples were collected and sent to be tested for influenza virus nucleic acid.The results showed that 2 samples were positive for influenza B virus nucleic acid.The epidemic situation had been effectively controlled after the implementation of various measures,and there had been no further cases since December 14,2017.CONCLUSIONS The reasons for the outbreak are that there was no isolation and treatment of patients in time and the measures of influenza prevention and control in schools were not in place.It is the most effective measures to prevent and control the outbreak of influenza in schools to strengthen morning inspection,isolate patients,improve the vaccination rate of influenza vaccine and do a good job of health education.