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目的回顾对1起聚集性上呼吸道感染疫情的成功处置,总结防控经验,为今后处理类似疫情能够提供参考。方法查阅疾病预防控制中心流行病学调查处理报告、医院临床病历和实验室检测资料,参照卫生部《流感样病例暴发疫情报告及调查处理指南(试行)》,制定防控措施。结果此次疫情持续时间20 d,呈单峰暴发,疫情范围局限于某动物保护基地内部,157名员工受到疫情威胁,共计确认发病44例,罹患率28.03%;主要临床表现为发热(最高38.8℃)、咳嗽、咽痛等上呼吸道感染症状;血常规检测:6例白细胞总数升高(10.8×109/L 20.5×109/L),3例中性粒细胞百分比升高(最高90.3%);咽拭子细菌学检测:5份培养出草绿色链球菌、1份培养出化脓性链球菌;病毒学检测:5份咽拭子样本病毒学快速检测,排除普通流感及禽流感病毒感染。所有发病患者痊愈,接触者中无二代病例发生。结论本次疫情是以草绿色链球菌为主,伴化脓性链球菌感染引起的聚集性上呼吸道感染疫情,疫情发生于动物保护基地且处于地震后防疫时期,需要考虑疫情与场所中动物及地震有无关联性;在暂时诊断不明的情况下,依据症状及体征建立病例定义有利于疫情形势判断,施与救治患者、医学观察密切接触者、症状监测、消毒及宣传教育措施可有效控制疫情。
Objective To review the successful treatment of a cluster of upper respiratory tract infections and summarize the experience in prevention and control so as to provide reference for the future treatment of similar epidemic situations. Methods Refer to Epidemiological Investigation and Treatment Report of CDC, clinical medical records of hospitals and laboratory test data, and refer to the “Guidelines for Surveillance and Treatment of Influenza-like Case Outbreaks (for Trial Implementation)” issued by the Ministry of Health to formulate prevention and control measures. Results The duration of the outbreak was unimodal at 20 days. The epidemic situation was confined within an animal protection base. 157 staff members were threatened by the epidemic. A total of 44 cases were confirmed as having an attack rate of 28.03%. The main clinical manifestations were fever (up to 38.8 (6) The total number of leukocytes increased (10.8 × 109 / L 20.5 × 109 / L), and the percentage of 3 neutrophils increased (up to 90.3%) ; Bacteriological examination of pharyngeal swab: 5 copies of Streptococcus viridans were cultured and one culture of Streptococcus pyogenes; virological test: 5 samples of throat swabs were rapidly tested for virology, excluding common flu and bird flu virus infection. All patients recovered, no cases of second-generation contacts occurred. Conclusion The epidemic situation is mainly Streptococcus viridans, with the accumulation of upper respiratory tract infection caused by Streptococcus pyogenes epidemic, the outbreak occurred in the animal protection base and in post-quake epidemic prevention period, the need to consider the epidemic and the site of animals and earthquakes Whether there is any correlation or not; in the case of temporary diagnosis is unknown, based on the symptoms and signs to establish the case definition is conducive to the judgment of the epidemic situation, the implementation and treatment of patients, close medical observation, symptom monitoring, disinfection and publicity and education measures can effectively control the outbreak.