上海市闵行区某民办中学聚集性肺结核疫情分析

 目的  分析上海市闵行区某民办中学一起肺结核聚集性疫情发生的情况。方法  对该校高三年级师生进行症状和摄片筛查,对疑似患者开展流行病学问卷调查,开展痰涂片、细菌培养及分子流行病学检测,并对阳性菌株进行全基因组测序。结果  该校高三某班1例肺结核患者(指示病例)的49名校内密切接触者中确诊肺结核10例,其中痰检阳性3例;扩大筛查范围时又确诊1例,且痰检阳性。针对指示病例和筛查发现的4例痰检阳性患者,分离培养的菌株基因型与该班前一年首发病例相同,指示有相互传播的可能。结论  本次疫情属于聚集性爆发疫情,可能由首发病例所导致。及时确诊和有效治疗学生肺结核患者,并对其密切接触者及时进行肺结核筛查,对控制学校肺结核爆发具有重要意义。

Analysis on aggregation outbreaks of pulmonary tuberculosis in a private middle school in Minhang District of Shanghai

Objective    To analyze the epidemiological characteristics of aggregation outbreaks of pulmonary tuberculosis (TB) in a private middle school in Minhang District ofShanghai.Methods    Symptom and radiographic screening were performed on the students of Grade 3 in this senior high school. Epidemiological survey,sputum smear,culture and molecular epidemiological examination were conducted on suspected patients.Whole genome sequencing was completed on positive strains.Results    In the screening of 49 close contacts with one TB patient (index case) in the school,a total of 10 patients with pulmonary TB were diagnosed,of which 3 cases were positive for culture.Another case was diagnosed and positive for culture after expanding the scope of screening. The genotype of the isolated strains from index case and the 4 patients positive for culture was identical to that of the first case of the classoneyear before,suggesting the transmission within the grade of Senior Three.Conclusions    This is an aggregation outbreak that may be attributable to the first patient with positive bacteria.Therefore,timely diagnosis and effective treatment of pulmonary TB patients,as well as timelyscreening of close contacts with pulmonary TB patients are significant to control potential outbreaks in schools.