某医院医务人员院内感染SARS的流行病学调查及分析

目的 调查某医院医务人员院内感染SARS的流行病学特征。方法 对此次SARS院内感染的相关人员进行流行病学调查。结果 共13例护理人员发生院内SARS感染,输入性传染源为一女性肿瘤患者的丈夫,这名确诊SRAS的丈夫在发病期间与其妻至少有2周医院内密切接触史。13例中8名是后来借调入该肿瘤患者入住科室的,她们感染SARS的平均潜伏期为12.6 d。对与13例SARS病例在潜伏期内(1例为发病早期)有密切接触者共57人进行追踪观察1月,结果无1例感染SARS。结论 SARS病人在潜伏期没有传染性或传染性不大。感染SARS与接触传染源的程度以及持续接触时间有关。SARS的发病可能与机体的免疫状况有关,SARS的病理基础可能与免疫损害有关。免疫抑制病人可能成为SARS的无症状病毒携带者和传染源。

Epidemiological investigation of nosocomial infection of SARS in medical staff of a hospital

Objective To investigate the epidemiological features of nosocomial infection of severe acute respiratory syndrome (SARS) in the medical staff of a hospital. Methods The medical staff associated with nosocomial infection of SARS in a hospital were investigated with standard procedures of epidemiological survey. Results The source of SARS infection was identified as the husband of a tumor patient who received chemotherapy in the Department of Oncology, during which they maintained intimate contact for at least two weeks when the husband had typical symptoms of SARS. The tumor patient had no any signs of SARS before her death. The mean latent period of SARS was 12.6 days in the 8 nurses transferred temporarily from other departments to assist in the management of the tumor patient. All 57 persons with close contact with the 12 medical staff suffering SARS in the latent period or with one having early-stage SARS did not show any signs of SARS during one month for observation in isolation. Conclusions SARS patients may have no or very limited infectivity during the latent period. Infection of SARS might be concerned with the intensity and persistence of contact with the infectious sources. The pathogenesis of SARS might involve the immune status of the potential patients, and immunodeficient individuals are at the risk of becoming asymptomatic carriers of SARS virus and the infectious sources.