一起院内传染性非典型肺炎感染的传播链分析

目的：调查一起严重急性呼吸综合征(SARS)院内感染的传播过程，分析造成院内感染的原因和流行病学特点，为预防和控制院内SARS感染提供可借鉴的资料。方法：采用统一的流行病学调查表，通过座谈了解，查看病案和感染现场调查相结合进行追踪和个案调查。绘制传播链说明本次院内感染的传播过程，描述发病时间分布、接触史和接触方式。结果：传染源为1名输入性病例，与该案例传播相关接触者54人，发病5人，总罹患率为9．26％。其中指征病例传播了1例和这名二代病例又传播了4例续发病例，其传播过程可以用清晰的传播链加以描述；此5例病例均与前代病例的症状期有密切接触史，发病潜伏期长，潜伏期平均10d以上；后对在症状期所有接触者进行隔离，无发病。结论：本案例中所有续发病例都有与症状期病例明确的近距离密切接触史，但密切接触者并非全部发病；病原体传播与环境条件有关；急诊科护士是SARS感染高危人群；院内SARS感染可防可制。

ANALYSIS ON ONE CASE OF SEVERE ACUTE RESPIRATORY SYNDROME OUTBREAK CHAIN OF TRANSMISSION IN HOSPITAL

Objective:To investigate the transmission proces s of severe acute res piratory syndrome (SARS) in hospital,to analyze the cause of infection and the epidemiological characteristics of SARS in hospital and to provide re ference data to prevent and control the infection in hospital Methods: Standar dized questionnaire was used on individual case combined with the interview, lo oking over the case of illness and the investigation of outbreak scene,the tran smission chains were depicted to illustrate the transmission process of SARS in hospital,the time distribution and contact types were described Results :The s ource of infection was an import case,54 contacts of index cases,5 cases were attacked through 2 or 3 generations,total attack rate was 9 26% The transmissi on chains of this outbreak could clearly be depicted These 5 cases have clear clos e contact history with former case during symptom period,the incubation period 10 days upwards average 18 hospital staff had contact with patients during incu bation or symptom period hadn't been attacked All contacts during symptom perio d were isolated, no on e was found ill Conclusion:All the secondary cases of this infe ction had a his tory of direct and close contacts to the index patients during symptom period,bu t clos e contacts were really not all attacked The commission of pathogen has obvious concern with surroundings The high-risk herd was nurse of emergency department SARS aggregative infection in hospital could be prevented and controlled