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目的分析某中学聚集性集中发热病例特征,探讨其流行病学危险因素、传播形式和病原体,为今后暴发疫情的处理提供依据。方法采用描述性方法对病例特征进行流行病学分析,检测病例麻疹、风疹IgM抗体,用PCR进行呼吸道多病原检测。结果共搜索131例发热病例,罹患率为8.7%(131/1 506)。发病高峰在4月17-19日。主要临床症状为发热(100.0%)伴头痛(55.0%)、咽痛(42.0%)、咳嗽(22.9%)、皮疹(40.0%)。病例集中发生在高一年级,其中高一(1)班罹患率高达45.2%。对病例间接触、校内、校外就餐等暴露因素进行单因素分析,暴露因素与疾病发生的关联强度均无统计学意义。麻风疫苗应急接种为此次暴发疫情的保护性因素(RR=0.38χ,2=2.31,P=0.000)。对18例急性期出疹病例进行麻疹、风疹双份血清IgM抗体检测均为阴性;8份咽拭子标本经呼吸道多病原检测均为阴性。结论根据流行病学史和临床诊断不能完全排除风疹、麻疹等病毒感染的可能。根据病例主要症状及实验室检查结果的临床特征,不排除细菌感染的可能性。
OBJECTIVE: To analyze the characteristics of a concentrated central fever in a middle school, discuss its epidemiological risk factors, transmission forms and pathogens, and provide the basis for future outbreaks. Methods The descriptive method was used to carry out epidemiological analysis on the characteristics of the cases. Measles and rubella IgM antibodies were detected and respiratory tract pathogens were detected by PCR. Results A total of 131 cases of fever were searched and the attack rate was 8.7% (131/1 506). The peak incidence in April 17-19. The main clinical symptoms were fever (100.0%) with headache (55.0%), sore throat (42.0%), cough (22.9%) and rash (40.0%). Cases occurred concentrated in the first year, of which one (1) class attack rate as high as 45.2%. Univariate analysis showed that there was no significant correlation between the exposure factors and the incidence of disease. Vaccination with leprosy vaccine was a protective factor for the outbreak (RR = 0.38χ, 2 = 2.31, P = 0.000). 18 cases of acute rash cases were measles, rubella double serum IgM antibody tests were negative; 8 throat swab samples were negative for multiple pathogenicity of the respiratory tract. Conclusion According to epidemiological history and clinical diagnosis can not completely rule out rubella, measles and other viral infections may. According to the clinical symptoms of the main symptoms and laboratory test results, does not rule out the possibility of bacterial infection.