石家庄地区133例儿童SARS-CoV-2感染流行病学特征

目的 研究石家庄地区儿童严重急性呼吸综合征冠状病毒2（severe acute respiratory syndrome coronavirus 2，SARS-CoV-2）感染的流行病学特征。方法 根据河北省卫生健康委员会官网发布的信息，收集2021年1月2日至30日24时石家庄地区报道的确诊SARS-CoV-2感染的133例0~18岁儿童的流行病学资料，对患儿的一般情况、发病地区、有无聚集、核酸筛查阳性情况等进行统计分析。结果 133例SARS-CoV-2儿童感染病例中，男65例，女68例，男：女为0.96：1。最小发病年龄为3个月7 d，平均发病年龄为（9±5）岁。90例患儿为家庭成员中首发感染病例，占67.7%。发病地区主要在石家庄藁城区，共108例（81.2%）；其中源于首例确诊病例所在的小果庄村38例（28.6%）。疫情发生后第2周SARS-CoV-2核酸检测阳性88例（66.2%）；在核酸筛查阳性前仅5例有不适症状。疫情发生后进行SARS-CoV-2核酸筛查，首次筛查阳性仅19例（14.3%）；≥ 4次筛查阳性70例（52.6%）。在校学生感染病例98例，74例（76%）为其家庭成员中首发病例；35例非在校学生感染病例中，16例（46%）为家庭成员中首发病例；两者比较差异有统计学意义（P < 0.05）。结论 石家庄地区确诊SARS-CoV-2感染的儿童，在家庭成员中为首发感染所占比例高，主要分布在藁城区农村地区，以学生多见，应重视学校聚集性感染的防控工作。SARS-CoV-2核酸检测呈阳性前多无症状，首次核酸筛查阳性率低，增加了疫情早期发现的难度。

Epidemiological features of severe acute respiratory syndrome coronavirus 2 infection in children in Shijiazhuang,China: an analysis of 133 cases

Objective To study the epidemiological features of children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Shijiazhuang, China. Methods Based on the information officially announced on the official website of the Health Commission of Hebei Province, epidemiological data were collected from 133 children, aged 0-18 years, who were diagnosed with SARS-CoV-2 infection in Shijiazhuang from January 2 to January 30, 2021. A statistical analysis was performed for general status, regional distribution, presence or absence of clusters, and results of SARS-CoV-2 nucleic acid tests. Results Among the 133 children with SARS-CoV-2 infection, there were 65 boys and 68 girls, with a male/female ratio of 0.96:1. The youngest age of onset was 3 months and 7 days, and the mean age of onset was (9±5) years. Of all the 133 children, 90(67.7%) were the first confirmed case of SARS-CoV-2 infection among their family members. Of all the children, 108(81.2%) came from the Gaocheng District in Shijiazhuang, among whom 38(28.6%) were from Xiaoguozhuang Village where the first patient with a confirmed diagnosis lived. SARS-CoV-2 nucleic acid test at week 2 after the outbreak showed positive results in 88 children (66.2%), and only 5 children had clinical symptoms before positive SARS-CoV-2 results were obtained. Of all the 133 children, 19(14.3%) were found positive in the first SARS-CoV-2 nucleic acid test after the outbreak, and 70(52.6%) had positive results for ≥4 times. There were 98 school students with infection, among whom 74(75.5%) were the first confirmed case in their family, and among 35 non-school students, 16(45.7%) were the first confirmed case in their family (P < 0.05). Conclusions Among the children confirmed with SARS-CoV-2 infection in Shijiazhuang, there is a high proportion of children who are the first confirmed case in their family, and the children are mainly distributed in the rural areas of Gaocheng. Most of these children are students, so the prevention and control of cluster infection in schools should be taken seriously. There are often no symptoms before SARS-CoV-2 nucleic acid test, with a low positive rate of the first nucleic acid test, which increases the difficulty of early discovery of the epidemic.