一起军营腺病毒急性呼吸道感染暴发流行的报告

目的 描述一起军营急性呼吸道感染暴发的临床特征和病原学诊断.方法 采用统一的流行病学个案调查表现场调查225例患者,描述疾病特征.30份咽拭子标本行病原学检测,中和试验检测52份急性期、恢复期患者的血清中和抗体.隔离患者和密切接触者,对空气、物品、地面进行全面消毒.结果 225例患者分布整个营区,有明显的宿舍聚集现象,聚集率为44.9%.225例患者中,全部有发热;161例有咳嗽,占71.6%;111例有咽痛,占49.3%;102例有头痛,占45.3%;31例有胸闷,占13.8%;4例有呼吸困难,占1.8%.咽拭子标本经PCR检测腺病毒基因阳性20份(66.7%),经HepG2、Hela、RD和Vero细胞培养,16份(53.3%)出现细胞病变;24例患者经IgM抗体筛查明确为腺病毒感染,双份血清中和试验证实28份腺病毒抗体有4倍以上升高.隔离患者、全面消毒后10 d,无新发病例.结论 此次暴发流行系腺病毒引起,及时、合理的预防措施能快速控制疾病的流行.

An outbreak of acute respiratory tract infection caused by Adenovirus in a military camp

Objective To describe the clinical characteristics and etiology diagnosis of an outbreak of acute respiratory tract infection in a military camp. Methods Two hundred and twenty-five cases were investigated using unified epidemiological questionnaires to describe the epidemiological characteristics. The etiological tests of 30 pharynx swab specimen were performed. The serum neutralized antibodies of 52 patients in acute and convalescence phases were detected by neutralization test. The patients and their close contacts were isolated. Air, stuffs and ground were all disinfected. Results Two hundred and twenty-five cases were distributed all the camp with obvious dormitory aggregation and the aggregation rate was 44. 9%. Among the 225 cases, all cases had fever and 161 (71.6%) had cough, 111 (49.3%) had pharyngalgia, 102 (45.3%) had headache, 31 (13.8%) had chest stuffy and 4(1. 8%) had dyspnea. Twenty (66. 7%) phargnxswab specimens turned to be adenorirus gene positive by polymerase chain reaction. Pharynx swab specimens were cultured in HepG2, Hela, RD and Vero cells, and 16 (53. 3%) presented with cytopathic changes. IgM antibody screening demonstrated that 24 cases were infected with Adenovirus, and neutralization test showed that antibodies increased ≥4 folds in paired sera from 28 cases. During 10 days after patient isolation and general disinfection, there was no new case of Adenovirus infection. Conclusions This outbreak of acute respiratory tract infection in a military camp was caused by Adenovirus, Timely andreasonable preventing measures can control the epidemic quickly.