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目的调查分析某部发生的一起肺炎支原体感染暴发疫情的流行特征和防控效果,提出进一步防控建议。方法采用流行病学现况研究方法,对所有病例的基本特征、临床表现和聚集性活动等进行个案调查。根据血清学检查和流行病学调查结果判定肺炎支原体感染情况。结果在2013年5月16日至2013年6月11日期间,某部队共出现49名确诊病例和38名疑似病例,均为男性,总体罹患率为7.8%。疫情高峰时间段为5月27日至6月2日(7 d),病例总数66人(占75.9%)。在疫情暴发期间,学兵10队、其他学兵队和非学兵队人群的罹患率分别为47.5%、4.5%和1.2%,其差异具有统计学意义(P<0.01)。49名确诊患者年龄为17~26岁,不同年龄组人群罹患率无统计学差异。患者籍贯和兵源地无明显聚集性。感染病例最常出现的临床症状为发热和咳嗽,62.5%确诊病例出现了单侧或双侧肺部炎性改变,肺部阳性体征少见。所有确诊病例均住院治疗,无重症或危重病例出现。在采取病例监测、隔离观察、取消密集性活动、分散居住以及预防性服用阿奇霉素等防控措施之后,疫情得到有效控制。结论封闭、密集的学习和训练部队易出现肺炎支原体感染暴发,有必要进一步提高防病意识,加强病例管理,尽量分散居住,减少密集活动,落实个人卫生制度。
Objective To investigate and analyze the epidemiological characteristics and prevention and control of an outbreak of Mycoplasma pneumoniae infection in a certain department and put forward further prevention and control suggestions. Methods Based on the epidemiological study methods, the basic characteristics, clinical manifestations and aggregation activities of all cases were investigated. According to serological tests and epidemiological findings to determine Mycoplasma pneumoniae infection. Results During the period from May 16, 2013 to June 11, 2013, a total of 49 confirmed cases and 38 suspected cases were reported in a unit, both men, with an overall attack rate of 7.8%. The peak period of the outbreak was from May 27 to June 2 (7 days), and the total number of cases was 66 (75.9%). During the epidemic outbreak, the attack rates of the 10 teams of military academies, other academicians and non-academicians were 47.5%, 4.5% and 1.2% respectively, with statistical significance (P <0.01). 49 confirmed patients aged 17 to 26 years old, different age groups, the attack rate was no significant difference. The patient origin and no obvious agglomeration. The most common clinical signs of infection were fever and cough, with unilateral or bilateral pulmonary inflammatory changes in 62.5% of confirmed cases and rare pulmonary signs. All confirmed cases were hospitalized, no serious or critically ill cases. The outbreak was effectively controlled after taking preventive and control measures such as case surveillance, isolation observation, desensitization of activities, decentralized living and prophylactic azithromycin. Conclusions Closure and intensive training and training of troops are prone to the outbreak of Mycoplasma pneumoniae infection. It is necessary to further raise the awareness of disease prevention and strengthen case management so as to disperse residence, reduce intensive activities and implement personal hygiene system.