广州市医务人员传染性非典型肺炎流行情况及预防控制效果分析

目的 分析广州市医务人员传染性生非典型肺炎(SARS)流行的基本特征,探讨流行因素,评价防制措施,为医疗卫生单位开展SARS收治及预防控制工作提供指导。方法 采用统一调查表对医务人员SARS患进行流行病学调查,采用定性生研究方法对医院SARS流行影响因素、预防控制措施及其效果进行调查,资料采用描述性流行病学方法分析。结果 广州市医务人员首例SARS患发病时间为2003年1月13日,截止5月5日共有29家医疗卫生单位报告医护人员发病280例,占全市总病例数的26．07％。医务人员发病高峰在2月上、中旬,共有167例,占医务人员发病总数的59．64％,呈明显聚集性。4月后病例为零星散发。病例主要集中在1月下旬前开始收治SARS患(对SARS尚缺乏认识的时期)的6家医院,占总病例数的73．2％(2c15／280)。调查180例医务人员SARS患中92．22％直接参与过SARS患的救治工作。采取定点收治患、加强医院病区通风、加强医护人员自身的个人防护等综合措施后,2月下旬开始,医务人员的新发SARS病例明显减少。结论 控制SARS在医务人员中流行的关键措施是：(1)要对出现SARS症状的患高度警惕,及时诊断并隔离患;(2)严格按照操作规范做好个人防护措施;(3)收治区要合理布局,严格区分污染区、半污染区和清洁区;(4)加强病区通风换气;(5)严格按照有关指引做好污染物、空气及环境的消毒工作。

SARS outbreak and control in hospital health care workers in Guangzhou

Objective Exploring the determinants of SARS epidemic and evaluating the corresponding control strategies through analyzing the epidemic characteristics among the health care workers, in order to guide the SARS case management and infection control in the health care settings. Methods Health care workers contracted SARS were interviewed with the uniform questionnaires, and field investigations for infection control measures and the effects were carried in the hospitals. Results A cumulative total of 280 SARS cases (accounting for 26.07% of the total cases reported) in health care workers in 29 health care settings from 13 January to 5 May 2003 and 92.22% of 180 SARS cases were infected during care delivery. The outbreak peak was in the first 20 days in February with 167 cases. 73.2% of the cases were in 6 hospitals received SARS patient before the end of January. The number of SARS cases declined dramatically after 20 February because of adopting the strategies including hospital designated for case admission, improving ventilation in wards and strengthening individual self protection. Conclusion The key for SARS control in health care settings was: 1. Early case identification and isolation; 2. Strict self protection 3. Nosocomial infection control 4. Improve ventilation in wards; 5. Strict disinfection measures.