石晶, 赵春艳, 张建明, 张国锋, 赵丹. 一起带状疱疹患者引起福利院水痘疫情暴发的调查[J]. 疾病监测, 2022, 37(4): 547-552. DOI: 10.3784/jbjc.202108280469
引用本文: 石晶, 赵春艳, 张建明, 张国锋, 赵丹. 一起带状疱疹患者引起福利院水痘疫情暴发的调查[J]. 疾病监测, 2022, 37(4): 547-552. DOI: 10.3784/jbjc.202108280469
Shi Jing, Zhao Chunyan, Zhang Jianming, Zhang Guofeng, Zhao Dan. An outbreak of varicella caused by herpes zoster in a welfare house[J]. Disease Surveillance, 2022, 37(4): 547-552. DOI: 10.3784/jbjc.202108280469
Citation: Shi Jing, Zhao Chunyan, Zhang Jianming, Zhang Guofeng, Zhao Dan. An outbreak of varicella caused by herpes zoster in a welfare house[J]. Disease Surveillance, 2022, 37(4): 547-552. DOI: 10.3784/jbjc.202108280469

一起带状疱疹患者引起福利院水痘疫情暴发的调查

An outbreak of varicella caused by herpes zoster in a welfare house

  • 摘要:
      目的  分析一起因带状疱疹引起某社会福利院水痘疫情暴发的调查处置情况,为预防和控制此类集体机构水痘疫情提供参考依据。
      方法  制定病例定义,查阅福利院健康监测表、考勤记录、传染病监测系统等开展病例主动搜索与个案调查。 采用描述性流行病学方法分析疫情流行病学特征。
      结果  2020年3月28日至4月28日该福利院共发生带状疱疹病例1例、水痘病例17例,水痘罹患率为27.87%(17/61),收养人员罹患率55.56%(15/27)高于工作人员罹患率5.88%(2/34),差异有统计学意义(χ2=18.47,P<0.001)。 收养人员中14岁及以下儿童罹患率较高,差异无统计学意义(P=0.45)。 收养人员水痘疫苗接种率11.11%,2剂次全程免疫接种率仅3.70%,无免疫史人群罹患率58.33%(14/24)高于有免疫史人群罹患率33.33%(1/3),差异无统计学意义(P=0.57)。 收养人员身体状况复杂,病程持续11~41 d,患病持续时间较长。 对首发病例及9例水痘临床诊断病例采集标本,经RT-PCR检测水痘−带状疱疹病毒核酸阳性。
      结论  本次福利院水痘疫情暴发传染源为罹患带状疱疹的护理员。 福利院收养人员身体状况复杂且采取集体生活方式,易发生传染病传播流行。 提高适龄儿童疫苗接种率,减少免疫空白,加强机构内传染病防控,鼓励相关工作人员入职前接种带状疱疹疫苗,可有效防控水痘−带状疱疹病毒传播流行。

     

    Abstract:
      Objective  To analyze the investigation and response of an outbreak of varicella caused by herpes zoster case in a social welfare house and provide reference for the prevention and control of similar outbreaks.
      Methods  The case definition was developed, and the health monitoring forms, attendance records and the infectious disease surveillance system of the welfare house were checked. Active case finding and investigation were conducted. Descriptive epidemiological methods were used to analyze the epidemiological characteristics of the epidemic.
      Results  From March 28 to April 28, 2020, a total of 1 case of herpes zoster and 17 cases of varicella occurred in the welfare house. The attack rate of varicella was 27.87% (17/61), and the attack rate in children living in the welfare house was 55.56% (15/27), higher than that in workers (5.88%, 2/34), the difference was significant (χ2=18.47, P<0.001) . Among the children living in the welfare house, the attack rate in those aged ≤14 years was higher, and the difference was not statistically significant (P=0.45). The rate of varicella vaccination in the children was 11.11%, and the full course immunization rate was only 3.70%. The attack rate in the children without immunization history was 58.33% (14/24), higher than that in those with immunization history (33.33%, 1/3), the difference had no significance (P=0.57). The health status of the children varied, the duration of the illness was 11–41 days, and the illness lasts for a long time. Samples were collected from the index case and 9 clinically diagnosed varicella cases, and these samples were varicella zoster virus (VZV) nucleic acid positive by RT-PCR.
      Conclusion  The source of the varicella outbreak in the welfare house was a nursing assistant suffering from herpes zoster. The health status of the children in the welfare home varied and they had a collective lifestyle, which was the risk factor for the spread of infectious diseases. Increasing the vaccination rate of school-age children, reducing the gaps in immunization, strengthening the prevention and control of infection, and encouraging relevant staff to be vaccinated with zoster vaccine before employment can effectively prevent and control the spread of VZV in welfare house and other similar settings.

     

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