2015 - 2017年苏州市学校结核病聚集性疫情调查

目的 分析学校结核病聚集性疫情的发生发展，为采取有效控制措施提供参考。方法 回顾性分析苏州市2015年1月 - 2017年12月发生的11起学校结核病聚集性疫情的发生情况；开展接触者筛查及随访追踪，判断患者之间的传播情况。结果 11起学校结核病聚集性疫情共13例指示患者，其中 9例涂阳肺结核、3例涂阴肺结核、1例结核性胸膜炎。传染病信息管理系统监测发现7例，校医报告发现3例，有6例发病在寒暑假。患者就诊延迟和诊断延迟时间延迟时间（中位数和四分位间距）分别为21（16.5，30.5） d和27（10.5，46） d。首次筛查密切接触者的患者检出率（4.68%）高于扩大筛查一般接触者（0.32%），1年随访期间共筛查出续发患者19例。结论 结核病聚集性疫情时有发生，结核病宣传教育、新生入学体检、疫情主动监测、接触者分级筛查和随访筛查等是有效防控学校结核病聚集性疫情的重要措施。

Epidemic analysis of school tuberculosis outbreak in Suzhou city between 2015 and 2017

Objective To analyze the occurrence and development of school tuberculosis outbreak, and provide the reference for effective control measures at schools. Methods Epidemic analysis was conducted on the data of 11 school-based tuberculosis outbreaks in Suzhou from January 2015 to December 2017. Contacts were screened and followed up to research the transmission between active tuberculosis patients. Results There were 11 school-based tuberculosis outbreaks in 13 index cases, including 9 cases of smear-positive tuberculosis, 3 cases of smear-negative tuberculosis, and 1 case of tuberculous pleurisy. 7 cases were detected by the Management Information System of Infectious Disease, 3 cases were reported by school doctor, and 6 cases felt ill during the winter and summer vacation. The patient delay and diagnosis delay time(median and interquartile distance) were 21 (16.5, 30.5) and 27 (10.5, 46) days, respectively. The detection rate (4.68%) of patients with first screening for close contacts was significantly higher than that(0.32%) of those with extended screening for general contacts. 19 tuberculosis patients were screened during the 1-year follow-up. Conclusion School tuberculosis outbreaks happen occasionally. Health education of tuberculosis, the physical examination of freshmen, active surveillance, stepwise screening of contacts, and follow-up screening are important measures for effective prevention and control of school tuberculosis outbreak.