学校及托幼机构流行性感冒疫情传播能力评估和停课措施效果评价

许玉成; 张瑞银; 周志峰; 钟剑明; 陈浩川; 赵梦蓝; 李学云

doi:10.16835/j.cnki.1000-9817.2021.02.028

学校及托幼机构流行性感冒疫情传播能力评估和停课措施效果评价

doi: 10.16835/j.cnki.1000-9817.2021.02.028

1.
广东省深圳市福田区疾病预防控制中心应急办公室, 518040
2.
深圳市妇幼保健院

基金项目:

2019年广东省医学科研基金项目 B2019165

深圳市福田区公益类科研项目 FTWS2020072

详细信息

作者简介:
许玉成(1989-)，男，广东汕头人，硕士，主管医师，主要研究方向为疾病控制

通讯作者:
李学云，E-mail：20115493@qq.com

中图分类号: G 478 R 183 R 511.7
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- 文章访问数: 542
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- PDF下载量: 59
- 被引次数: 0
出版历程
- 收稿日期: 2020-07-08
- 修回日期: 2020-08-23
- 网络出版日期: 2021-04-06
- 刊出日期: 2021-02-25

Assessment of transmission capacity of influenza and effect evaluation of suspension measures in schools and nurseries

1.
Office of Emergenly Response, Futian District Center for Disease Control and Prevention, Shenzhen(518040), Guangdong Province, China

摘要

摘要: 目的评价学校及托幼机构流行性感冒聚集性疫情传播能力和停课措施效果，为制定疾病管理策略和控制措施提供依据。方法采用SEIAR动力学模型对深圳市福田区学校发生的流行性感冒疫情数据进行模拟，计算疫情的基本再生系数(R₀)来评价疫情传播能力，计算疫情的累计罹患率来评价停课措施的防控效果。结果学校流感疫情无干预情况下R₀值为8.44(8.01，8.89)，不同类型学校流感疫情R₀值差异有统计学意义(F=9.52，P < 0.01)，中小学校流感疫情的R₀值高于托幼机构(P < 0.05)；A型流感疫情R₀值高于B型流感(t=2.71，P < 0.01)，A型H3亚型流感疫情R₀值高于B型Victoria系(P < 0.05)；停课4，7 d的疫情累计罹患率低于不采取停课措施的疫情(P < 0.05)，而停课4 d与7 d的疫情累计罹患率差异无统计学意义(P>0.05)。结论学校流感疫情传播能力强，中小学校高于托幼机构；在涉疫班级达到停课标准时，建议停课4 d。
- 流感, 人 /
- 疾病暴发流行 /
- 组织和管理 /
- 日托幼儿园 /
- 学生保健服务
Abstract: Objective To estimate the transmission capacity of influenza clustering in schools and nurseries, and to evaluate the effect of suspension measures, providing a basis for formulating disease management strategies and control measures. Methods The SEIAR dynamics model was used to simulate the epidemic data, calculating the basic regeneration coefficient R₀ of the epidemic to evaluate the epidemic transmission capacity, and calculating the cumulative incidence rate of the epidemic to evaluate the prevention and control effect of the suspension measures. Results The basic regeneration coefficient R₀ was 8.44(8.01, 8.89) without intervention. There were statistically significant differences in R₀ of influenza epidemic among different types of school(F=9.52, P < 0.01). The R₀ of influenza epidemic in primary and secondary schools were higher than that in nurseries(P < 0.05). R₀ of influenza A was higher than that of influenza B(t=2.71, P < 0.01). R₀ of influenza A(H3) was higher than of influenza B(Victoria)(P < 0.05). The cumulative incidence of the outbreaks which were suspended for 4 days and 7 days was significantly lower than that in the non-suspensions(P < 0.05). However, there was no significant difference in the cumulative incidence of the outbreaks between the 4-day suspension and the 7-day suspension(P>0.05). Conclusion Transmission capacity of school-based influenza epidemic is high, especially among primary and secondary schools. When the epidemic situation of infected class meets the suspension standard, it is recommended to suspend classes for 4 days.
- Influenza, human /
- Disease outbreaks /
- Organization and administration /
- Child day care centers /
- Students health services

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表 1 不同停课措施在不同类型学校累计罹患率比较(%，95%CI)

Table 1. Comparison of cumulative incidence of different suspension measures in different types of schools (%, 95%CI)

停课措施	托幼机构(n=8)	小学(n=42)	中学(n=10)	合计(n=60)
无	99.00(98.63, 99.30)	99.79(99.75, 99.81)	99.82(99.76, 99.89)	99.69(99.59, 99.76)
停课4 d	5.38(4.13, 6.78)	7.41(4.75, 10.80)	13.06(6.63, 20.42)	8.08(5.82, 10.68)
停课7 d	4.46(3.65, 5.23)	5.23(2.98, 8.22)	9.24(4.31, 16.41)	5.79(4.00, 8.21)
H值	15.87	85.65	19.73	121.73
P值	<0.01	<0.01	<0.01	<0.01

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表 2 不同停课措施在不同病毒型别/亚型/系疫情累计罹患率比较(%，95%CI)

Table 2. Comparison of cumulative incidence of different suspension measures by virus types/subtypes/ lineage (%, 95%CI)

停课措施	A型(n=36)	B型(n=24)	H1型(n=12)	H3型(n=24)	Victoria系(n=12)	Yamagata系(n=12)
无	99.76(99.67, 99.82)	99.59(99.39, 99.74)	99.69(99.54, 99.82)	99.79(99.69, 99.86)	99.42(99.06, 99.70)	99.75(99.68, 99.82)
停课4 d	10.38(6.82, 14.29)	4.65(3.42, 5.88)	5.90(3.92, 7.89)	12.62(7.40, 19.10)	3.99(2.78, 5.27)	5.30(3.15, 7.53)
停课7 d	7.60(4.73, 11.24)	3.08(2.42, 3.81)	3.78(2.63, 5.00)	9.51(5.01, 14.70)	2.89(2.05, 3.88)	3.27(2.21, 4.51)

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