一起“挪威疥疮”医院内暴发与处置

目的调查某院一起疥疮医院感染暴发的原因和处置方法。方法 2013年5月该院因1例"挪威疥疮"患者误诊,引起医务人员疥疮医院感染暴发,该院医院感染控制科对暴发事件进行流行病学调查,并根据调查结果指导医疗及消毒隔离。结果医务人员及其家属,共计27人感染挪威疥疮。经积极药物治疗,患者病情逐渐好转;患者使用过的物品全部用塑料口袋包装密封1周后进行清洗消毒。经积极治疗加严格清洗消毒后,感染流行趋势得到控制,未再出现新发病例。结论挪威疥疮传染性高,可在局部地区造成流行,需提高医务人员对本病的诊断能力;一旦发生医院感染,应采取快速、有效措施,防止其蔓延、扩散。     

一起挪威疥疮医院感染暴发的调查与防控

目的了解某院一起挪威疥疮医院感染暴发的流行病学特点,为临床预防和控制医院感染提供依据。方法采用现场流行病学调查方法,对全部可疑感染者和密切接触者进行调查并追踪,描述患者三间分布,制定并落实一系列有效的综合防控措施。结果 2015年11月3—16日共有16例人员发生挪威疥疮感染,发病例数最多的时间为11月11日(5例),发病时间集中在11月9—11日,共10例,占发病总数的62.50%。16例病例空间分布:综合内科12例、护理部2例、员工家庭2例。人群分布:主要为50~59岁患者(7例)、女性(13例)、护理人员(9例)。采取综合防控措施、使用药物治疗后,16例病例均痊愈,治愈率为100%。病区内和医院内无新发病例出现,疫情得到控制。结论挪威疥疮具有高度接触传染性,可在局部地区造成流行。为避免疥疮在医院内感染蔓延、扩散,医务人员需加强对该病的诊断及防护水平。     

一起医务人员疥疮医院感染暴发的应急对策

目的 探讨疥疮医院感染暴发的应急对策.方法 医院2011年2月因1例挪威疥疮引起医务人员疥疮医院感染暴发,采取流行病学调查分析和医疗干预落实环境消毒措施.结果 调查接触暴露的医务人员60名,其中医务人员感染疥疮26例,感染率为43.33％;迅速诊断首发病例,给予疥疮相关知识的教育指导,感染者和接触暴露者使用药物治疗或预防,环境消毒等措施得到落实;一周内感染流行得到了控制.结论 挪威疥疮具有高度接触传染性,可能导致医院感染暴发;避免疥疮医院感染蔓延扩散,须采取快速、彻底的措施.     

血液净化中心疥疮暴发的处置与防控

疥疮是疥螨在人体皮肤表皮层内引起的接触性传染性皮肤病,易在人员密集区流行.通过对某三级甲等医院一起血液净化中心疥疮暴发的感染事例的分析,探讨预防疥疮的相关措施,为相关科室感染控制提供借鉴.此次疥疮感染主要发生在有高危易感因素的维持性血液透析患者中.通过从时间、空间、人群3个方面归纳其流行病学特征,落实调查、治疗、防控等...     

一起工地疥疮暴发的调查

2004年9月2日至20日，禹城市安仁镇一民营石灰厂工地发生一起疥疮暴发。经及时诊断和调查处理．疫情迅速被控制，现报告如下。     

1起中学疥疮暴发的调查

疥疮(Scabies)自50年代末已在我市基本消除,近年来,很少有病例发生。1999年4月1日～5月26日,某镇中心中学发生一起疥疮暴发,现将调查情况报告如下:1 流行病学特征1.1 流行范围 该学校4个年级,16个班,在校学生1067人,共发病49人,罹患率为4.59％(49/1067),各年龄均有发病,     

对一起医院发生医院感染暴发流行事件的启示

医院感染 (ＨＡＩ)是指病人入院时既不存在又不处于其潜伏期的感染 ,是现代医疗实践的必然产物。可分为内源性和外源性感染 ,前者是指来自病人体内 ,大多因长期受肿瘤等疾病的影响致免疫水平低下引起 ,在我国发生ＨＡＩ病例中 ,占 30 %左右 ,目前的确难以避免 ;后者是指由于非患者本身的原因引起的感染 ,约占 70 % ,是可以避免的 ,但至今却未能避免。主要是由于医院不少领导对ＨＡＩ管理工作意识淡薄 ,硬件不“硬” ,管理不善 ,有章不循或无章可循所致。广东省卫生防疫站于 1998年先后对全省 12家三级甲等医院ＨＡＩ情况进行了调查 ,结果不…     

一起中学生暴发型疥疮流行报告

1997年9月26日～11月22日,高安市相城中学发生一起暴发型皮肤病。经流行病学调查、临床分析,实验室检验,证实为一起暴发型疥疮流行。现将调查结果报告如下。1　流行病学调查　(1)发病时间分布:9月26日该校刘某首例发病,随后9月27～30日陆续发病38例;10月发病65例,11月发病55例,历时59天。先后共有158人发病,其中男82人,女76人。年龄最小的13岁,最大的18岁。在校学生1560人,总罹患率10.128%。从发病时间看,本次流行特点是从与病人有效接触后暴发流行,病人出现较集中,在时间上有一定连续性,无明显高峰期。(2)单位分布:158例疥疮患者中,各年级…     

综合医院暴发疥疮感染的流行病调查与分析

目的分析综合医院疥疮感染暴发的特点,为综合医院预防控制疥疮暴发及预防提供警示。方法对综合性医院疥疮感染暴发事件的流行病学调查和分析。结果疥疮感染16例患者,属于医院感染暴发事件,保洁员是主要的传播者。结论保洁人员防护意识差、医务人员疥疮防治知识匮乏,误诊是暴发疥疮的主要原因,医务人员的值班室是造成间接传播的重要场所。     

一起学生疥疮暴发流行的报告

1991年12月8日至1992年1月底，东胜市第四中学（农村中学）发生了疥疮暴发流行。现将调查处理结果报告如下：1．一般情况调查与分析1．1调查：该校位于距东胜市65公里的油江海乡。全校共有8个班514名学生。男生276名，女生238名。学生全部来自农村，80％以上的学生住校。学校共有34个宿舍，每个宿舍有一盘土炕。其中有3个大宿舍，每间约40m’住舢至22人，其余31个是小宿舍每间约25m’住12至13人，人均居住面积约2m’，比较拥挤，卫生很差。1991年12月8日至1992年三月底，该校共发生疥疮58例，发病率为11．28％（58／514）。发病年龄最小的12…     

An outbreak of scabies in a teaching hospital: lessons learned.

OBJECTIVE: To investigate an outbreak of scabies in an inner-city teaching hospital, identify pathways of transmission, institute effective control measures to end the outbreak, and prevent future occurrences. DESIGN: Outbreak investigation, case-control study, and chart review. SETTING: Large tertiary acute-care hospital. RESULTS: A patient with unrecognized Norwegian (crusted) scabies was admitted to the acquired immunodeficiency syndrome (AIDS) service of a 940-bed acute-care hospital. Over 4 months, 773 healthcare workers (HCWs) and 204 patients were exposed to scabies. Of the exposed HCWs, 147 (19%) worked on the AIDS service. Risk factors for being infested with scabies among HCWs included working on the AIDS service (odds ratio [OR], 5.3; 95% confidence interval [CI95], 2.17-13.15) and being a nurse, physical therapist, or HCW with extensive physical contact with infected patients (OR, 4.5; CI95, 1.26-17.45). Aggressive infection control precautions beyond Centers for Disease Control and Prevention barrier and isolation recommendations were instituted, including the following: (1) early identification of infected patients; (2) prophylactic treatment with topical applications for all exposed HCWs; (3) use of two treatments 1 week apart for all cases of Norwegian scabies; (4) maintaining isolation for 8 days and barrier precautions for 24 hours after completing second treatment for a diagnosis of Norwegian scabies; and (5) oral ivermectin for treatment of patients who failed conventional therapy. CONCLUSIONS: HCWs with the most patient contact are at highest risk of acquiring scabies. Because HCWs who used traditionally accepted barriers while caring for patients with Norwegian scabies continued to develop scabies, we found additional measures were required in the acute-care hospital. HCWs with skin exposure to patients with scabies should receive prophylactic treatment. We recommend (1) using heightened barrier precautions for care of patients with scabies and (2) extending the isolation period for 8 days or 24 hours after the second treatment with a scabicide for those patients with Norwegian scabies. Oral ivermectin was well tolerated for treating patients and HCWs who failed conventional treatment. Finally, we developed a surveillance system that provides a "barometric measure" of the infection rate in the community. If scabies increases in the community, a tiered triage system is activated to protect against transmission among HCWs or hospital patients.     

An outbreak of xylene intoxication in a hospital

On January 3, 1980 an outbreak of illness occurred in 15 employees of a small community hospital. Symptoms included headache, nausea, vomiting, and dizziness or vertigo; the duration of illness ranged from 2 to 48 hours. The employees who became ill all worked in areas of the hospital served by one central ventilation system. None of the 180 persons working in other parts of the hospital developed symptoms requiring medical care. Less than 1 hour before the outbreak occurred, 1 liter of liquid xylene had been discarded down a sink drain in the pathology laboratory. Simulation experiments confirmed that xylene vapor could have been drawn into the room that contained the fan unit of the ventilation system. This outbreak illustrates an unusual route of exposure to a widely used laboratory chemical.     

一起医院内季节性流行性感冒暴发调查

目的对一起医院内流行性感冒（流感）暴发进行调查和处置,为医院流感暴发的预防与控制提供参考。方法2014年7月29日-8月7日某院神经外科出现8例流感样感染者,对其进行流行病学调查,采集患者咽拭子标本进行实验室检测。结果8例感染者中神经外科医务人员6例,医务人员家属和患者各1例,感染者症状以低热、咽痛、全身乏力为主。该科室共有患者及医务人员67例,流行性感冒罹患率为11.94％,同期医院其他科室无类似感染者。6例感染医务人员咽拭子检测结果为季节性H3型流感病毒核酸阳性。医院感染管理办公室介入调查,神经外科积极进行隔离与抗病毒治疗,暴发得到有效控制。结论此起医院感染暴发为季节性H3型流感暴发,医院在开启中央空调时应加强病室开窗通风及环境消毒,同时流感流行季节应对医务人员进行流感疫苗接种,加强监测,预防医院内流感暴发。     

An outbreak of tuberculosis in a children's hospital

A 3-year-old girl was admitted to a children's hospital; subsequently her mother was found to have pulmonary tuberculosis with smear-positive sputum. Of over 400 patients, their families and staff at risk in the hospital, 30 inpatients, three outpatients, two sibling visitors and one staff member became infected. A retrospective cohort study of exposed inpatients identified exposure duration, exposure proximity and primary diagnosis as independent predictors of infection risk. Children with neoplastic disease who were being treated with cytotoxic and immunosuppressive therapy with clotting factors were at a greater risk of developing clinical disease including disseminated infection. Altogether three generations of infected children and adults were diagnosed amongst community and hospital contacts in this extended outbreak. These findings support current recommendations for the follow-up of highly susceptible casual contacts of cases of pulmonary tuberculosis with smear-positive sputa.     

Nosocomial outbreak of scabies in a psychiatric hospital--epidemiological assessment and prophylactic treatment with oral ivermectin

OBJECTIVES: To evaluate the effectiveness of mass treatment with ivermectin of scabies outbreak in institutional settings. To determine the factors, such as host susceptibility and scabetic exposure level associated with the onset of scabies. METHODS: The authors investigated a nosocomial scabies outbreak in a close psychiatric ward. The index case was a man with steroid-induced localized crusted scabies. Twenty-six patients were diagnosed with scabies, 4 of them had relapse of scabies, while no staff was infested. Despite frequent surveillance and treatment of symptomatic patients with 1% gamma-benzenehexachloride (gamma-BHC: Lindane), new cases were observed. Thus, all 69 patients in the ward were treated with ivermectin (200 microg/kg) simultaneously on day 105 of the outbreak (the mass treatment). Patients who had scabies were compared with patients who had no scabies in terms of age, body weight, diabetes, physical functions, topical administration of corticosteroid, proximity to the index patient, and problematic behavior. RESULTS: The mass treatment was implemented without a significant adverse event. Although two patients developed symptoms of scabies after the mass treatment, no patient in the ward had been diagnosed with scabies since the 98th day of the treatment. Regarding factors associated with the scabies onset, the only statistically significant factor was proximity to the index patient with crusted scabies. CONCLUSIONS: Oral ivermectin was safe and effective for controlling scabies in institutional settings. The exposure level to scabetic mites was more important than host susceptibility in determining the risk of scabies onset.     

An outbreak of viral gastroenteritis in a psychiatric hospital

In September and October 1987, an outbreak of gastroenteritis due to small round structured viruses occurred in a large psychiatric hospital. A total of 149 people, 83 patients and 66 members of staff, were affected over a 26-day period. Most cases were associated with three psychogeriatric wards. The outbreak highlighted the special problems of infection control in long-stay psychiatric units and methods of overcoming these difficulties are discussed.