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目的:为了明确输入性SARS病例在广西引起易感人群传染的危险性以及影响病毒传播的危险因素,为预防SARS在广西的再度流行提供科学依据。方法:①应用回顾性研究和随访研究的流行病学方法收集2003年在广西发生的两个疫点中的输入性和继发性SARS病例资料,应用描述流行病学方法描述每个输入性病例引起继发性病例传播的传播链。②通过对输入性SARS病例到继发性病例的发生的流行病学调查资料和传播链的分析,找出影响输入性病例传播的危险因素。③应用血清流行病学方法,于2003年5月及2005年11月分别两次对此两疫点发生的输入性、继发性SARS病例、家庭成员及密切接触者、参与诊治的医护人员进行血清流行病学调查。应用ELISA法检测研究对象血清中的SARS冠状病毒抗体IgG和IgM。结果:参与诊治先证A诊治的全部医护人员的继发性隐性感染率为2·1%(2/97),显著低于参与先证A护理的亲属的继发性发病率41·7%(5/12)(P<0·01)。参与先证A1护理的亲属9人中,有5人属于继发性隐性感染,继发性感染率为55·6%(5/9),远高于医护人员的继发性感染率4%(3/75)(P<0·01)。结论:输入性SARS病例如果IgM、IgG双抗体阳性者病毒的传染力极强,第2代病例可能由于病毒的变异而导致毒力下降。广西输入性病例引起第2代病例的感染主要原因是通风不良、近距离无防护密切接触;通风良好可以降低空气中的病毒浓度,即使出现感染,也仅引起隐性感染;气候是影响SARS的流行重要因素之一。
Objective: In order to clarify the risk of SARS-induced SARS in Guangxi and the risk factors affecting the transmission of SARS in Guangxi, it provides a scientific basis for prevention of SARS recurrence in Guangxi. Methods: (1) The epidemiological methods of retrospective study and follow-up study were used to collect the data of imported and secondary SARS cases in two epidemic areas in Guangxi in 2003. Descriptive epidemiological methods were used to describe each imported case Propagation chain that causes the transmission of secondary cases. (2) Through the analysis of epidemiological survey data and transmission chain of imported SARS cases to secondary cases, identify the risk factors that affect the transmission of imported cases. (3) Serological epidemiological methods were used to investigate the incidence of imported SARS cases, family members and close contacts in both epidemic areas in May 2003 and November 2005 respectively Seroepidemiological survey. Serum samples of SARS-CoV IgG and IgM were tested by ELISA. Results: The secondary latent infection rate of all the medical staff participating in the diagnosis and treatment of primary A was 2. 1% (2/97), which was significantly lower than that of the relatives participating in the first cardinal A care 41.7 % (5/12) (P <0 · 01). Of the 9 relatives who participated in the First Aid Care, 5 were secondary latent infections with a secondary infection rate of 55.6% (5/9), much higher than the secondary infection rate of medical staffs 4 % (3/75) (P <0 · 01). CONCLUSIONS: In the case of imported SARS cases, if the IgM and IgG double antibody positive are highly contagious, the second generation of cases may result in the decrease of virulence due to the mutation of the virus. Guangxi imported cases caused by the second generation of cases of infection is mainly due to poor ventilation, close contact with no protection; good ventilation can reduce the concentration of virus in the air, even if the infection, it only causes latent infection; climate is the impact of SARS One of the important factors of popularity.