上海市静安区小学一起甲型流感暴发疫情分析

倪晓芬; 陈红; 周洲; 蔡明毅; 姚慧洁

doi:10.16835/j.cnki.1000-9817.2023.04.029

上海市静安区小学一起甲型流感暴发疫情分析

doi: 10.16835/j.cnki.1000-9817.2023.04.029

上海市静安区疾病预防控制中心急性传染病防制科，200072

详细信息

作者简介:
倪晓芬(1988-)，女，上海市人，大学本科，主管医师，主要从事急性传染病防制工作

通讯作者:
陈红，E-mail：chenhong@jingancdc.net

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G478 R181.3 R571
计量
- 文章访问数: 513
- HTML全文浏览量: 251
- PDF下载量: 70
- 被引次数: 0
出版历程
- 收稿日期: 2023-02-01
- 修回日期: 2023-03-21
- 网络出版日期: 2023-04-26
- 刊出日期: 2023-04-25

Analysis of an outbreak of influenza A in a primary school in Jing'an District, Shanghai

Department of Acute Infectious Diseases Control and Prevention, Jing'an Center for Disease Control and Prevention, Shanghai(200072), China

摘要

摘要: 目的了解上海市某小学一起甲型流感暴发疫情的流行病学资料，为探索针对性防控措施提供参考。方法采用现场流行病学方法，通过现场随访和电话回访卫生老师及病例的方式，调查收集2022年11月8日至12月6日静安区某小学甲型流感暴发疫情资料，采用描述流行病学方法分析疫情的分布特征。结果首发病例于2022年11月8日上午出现咳嗽、咽痛、发热症状，体温最高达38.6 ℃。本起暴发疫情累计报告流感样病例99例，其中学生92例，教师7例，总罹患率为9.45%。所有病例的临床症状均有发热、咽痛及咳嗽，经医院快诊试剂诊断为甲流病例27例。二年级学生病例罹患率最高(24.46%)，不同年级学生病例罹患率差异有统计学意义(χ²=48.28，P＜0.01)；教学楼二楼病例罹患率最高(23.47%)，不同楼层病例罹患率差异有统计学意义(χ²=52.38，P＜0.01)。病原学检测显示，导致该次暴发的流感病毒为甲型H3N2病毒。结论该次疫情是一起由甲型H3N2流感病毒引起的校园聚集性疫情。卫生与教育部门之间应加强合作，有效落实传染病防控措施，及时找出传染源，切断传播途径。
- 流感，人 /
- 疾病暴发流行 /
- 流行病学研究 /
- 学生
Abstract: Objective To investigate the epidemiological data of an outbreak of influenza A in a primary school in Shanghai, to provide reference for targeted prevention and control measures. Methods A field epidemiological method was used to investigate and collect the data of influenza A outbreak in a primary school in Jing'an District from November 8 to December 6, 2022, through on-site follow-up and telephone return visit to health teachers and cases. The distribution characteristics of the epidemic were analyzed by descriptive epidemiology. Results The first case developed symptoms of cough, sore throat, and fever on the morning of November 8th 2022, with a maximum body temperature of 38.6 ℃. Later, the clinical diagnosis was influenza A. The total number of influenza like cases reported in this outbreak is 99, including 92 students and 7 teachers. The total incidence rate was 9.45%. The clinical symptoms of all cases were fever, sore throat, and cough; 27 cases of influenza A were diagnosed by hospital rapid diagnostic reagents. The second grade students had the highest case incidence rate(24.46%), and there was a statistically significant difference in case incidence rates among students of different grades (χ²=48.28, P < 0.01). The case incidence rate on the second floor was the highest (23.47%), and there was a statistically significant difference between the case incidence rates on different floors (χ²=52.38, P < 0.01). Etiological testing showed that the influenza virus causing this outbreak was type A H3N2 virus. Conclusion This outbreak is a campus cluster outbreak caused by influenza A (H3N2) virus. The health and education departments should strengthen cooperation to effectively implement prevention and control measures of infectious diseases, and timely identify the source of infection and cut off the transmission route.
- Influenza, human /
- Disease outbreaks /
- Epidemiologic studies /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

图 1 上海市静安区某小学甲型流感病例暴发流行曲线

Figure 1. Epidemiological curve of influenza A cases outbreak in a primary school in Jing'an District, Shanghai

下载: 全尺寸图片幻灯片

表 1 不同组别小学生甲型流感罹患率比较

Table 1. Comparison of influenza A incidence rates among primary school students in different groups

组别	选项	人数	罹患人数	χ²值	P值
年级	一	178	9(5.06)	48.28	＜0.01
	二	184	45(24.46)
	三	181	15(8.29)
	四	181	18(9.94)
	五	212	5(2.36)
楼层	一	149	4(2.68)	52.38	＜0.01
	二	213	50(23.47)
	三	181	15(8.29)
	四	181	18(9.94)
	五	212	5(2.36)
性别	男	490	48(9.80)	0.01	＞0.05
	女	446	44(9.87)
注： ()内数字为罹患率/%。

下载: 导出CSV

参考文献(12)

[1]	吴迪, 蔡明伟, 陆剑云, 等. 广州市某高中一起甲型流感暴发疫情流行病学调查分析[J]. 医学动物防制, 2021, 37(9): 898-905. https://www.cnki.com.cn/Article/CJFDTOTAL-YXDZ202109023.htm WU D, CAI M W, LU J Y, et al. Epidemiological investigation and analysis of an influenza a outbreak in a high school in Guangzhou City[J]. J Med Pest Control, 2021, 37(9): 898-905. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YXDZ202109023.htm
[2]	刘晴晴, 姚云萱, 杨振华, 等. 上海北部某院流感样病例流感病毒监测分析[J]. 国际检验医学杂志, 2022, 43(15): 1881-1884. https://www.cnki.com.cn/Article/CJFDTOTAL-GWSQ202215019.htm LIU Q Q, YAO Y X, YANG Z H, et al. Surveillance and analysis of influenza virus in influenza like illness in a hospital in northern Shanghai[J]. Int J Lab Med, 2022, 43(15): 1881-1884. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GWSQ202215019.htm
[3]	张晓峰, 尤爱国, 安勇进, 等. 三门峡市某中学一起H3N2流感暴发疫情调查[J]. 河南医学研究, 2021, 30(27): 5035-5039. doi: 10.3969/j.issn.1004-437X.2021.27.012 ZHANG X F, YOU A G, AN Y J, et al. An outbreak epidemic investigation of H3N2 influenza in a middle school in Sanmenxia City[J]. Henan Med Res, 2021, 30(27): 5035-5039. (in Chinese) doi: 10.3969/j.issn.1004-437X.2021.27.012
[4]	国家卫生健康委员会. 关于印发流感样病例暴发疫情处置指南(2018年版)的通知[A]. 2018-11-14. National Health Commission of the PRC. Notice on the issuance of guidelines for the handling of outbreaks of influenza-like cases (2018 Version)[A]. 2018-11-14. (in Chinese)
[5]	孔德广, 房莉, 孟派, 等. 武汉市一起小学B型流感暴发疫情分析[J]. 应用预防医学, 2022, 28(4): 377-379. https://www.cnki.com.cn/Article/CJFDTOTAL-GXYX202204022.htm KONG D G, FANG L, MENG P, et al. Analysis of an outbreak of influenza B in a primary school in Wuhan[J]. Appl Prev Med, 2022, 28(4): 377-379. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GXYX202204022.htm
[6]	胡飞飞, 张钧, 陈聪, 等. 江苏省苏州市某幼儿园一起流感暴发疫情调查[J]. 医学动物防制, 2020, 36(4): 318-320. https://www.cnki.com.cn/Article/CJFDTOTAL-YXDZ202004004.htm HU F F, ZHANG J, CHEN C, et al. Investigation on an outbreak of influenza in a kindergarten in Suzhou, Jiangsu Province[J]. J Med Pest Control, 2020, 36(4): 318-320. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YXDZ202004004.htm
[7]	魏叶, 朱平, 袁建明, 等. 江苏省南通市一起小学流感暴发疫情的调查分析[J]. 医学动物防制, 2018, 34(5): 484-486. https://www.cnki.com.cn/Article/CJFDTOTAL-YXDZ201805023.htm WEI Y, ZHU P, YUAN J M, et al. Investigation and analysis of outbreak of influenza in a primary school in Nantong City of Jiangsu Province[J]. J Med Pest Control, 2018, 34(5): 484-486. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YXDZ201805023.htm
[8]	张俊婕, 周祺, 刘敏, 等. 上海市某小学1起流行性感冒暴发调查[J]. 预防医学论坛, 2020, 26(3): 176-178. https://www.cnki.com.cn/Article/CJFDTOTAL-YXWX202003006.htm ZHANG J J, ZHOU Q, LIU M, et al. Investigation on an influenza outbreak in a primary school, Shanghai City[J]. Prev Med Trib, 2020, 26(3): 176-178. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YXWX202003006.htm
[9]	李海霞, 盛晟, 杨坚波. 2017—2019年无锡市新吴区流感暴发疫情流行特征及影响因素[J]. 公共卫生与预防医学, 2021, 32(6): 75-78. https://www.cnki.com.cn/Article/CJFDTOTAL-FBYF202106018.htm LI H X, SHENG S, YANG J B. Epidemic characteristics and influencing factors of influenza outbreaks in Xinwu District of Wuxi in 2017-2019[J]. J Public Health Prev Med, 2021, 32(6): 75-78. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-FBYF202106018.htm
[10]	高跟霞, 杨军鹏, 鲁朝霞, 等. 2021年靖远县某镇中心幼儿园一起乙型流感暴发疫情调查[J]. 疾病预防控制通报, 2022, 37(4): 23-25. https://www.cnki.com.cn/Article/CJFDTOTAL-DFBT202204006.htm GAO G X, YANG J P, LU Z X, et al. An outbreak of influenza B was 2021 at a kindergarten in a town in Jingyuan County[J]. Bull Dis Control Prev, 2022, 37(4): 23-25. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-DFBT202204006.htm
[11]	陈法辉, 黄文彪, 黄奕强. 中小学校内流感暴发特征、学生心理应激反应及其防控[J]. 黑龙江医学, 2020, 44(5): 675-677. https://www.cnki.com.cn/Article/CJFDTOTAL-HLYX202005044.htm CHEN F H, HUANG W B, HUANG Y Q. Characteristics of influenza outbreak in primary and secondary schools, psychological stress response of students and its prevention and control[J]. Heilongjiang Med, 2020, 44(5): 675-677. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-HLYX202005044.htm
[12]	于秋燕, 吕燕, 高尚, 等, 济南市学校流感样病例暴发流行特征及影响因素分析[J]. 中国公共卫生管理, 2020, 36(6): 897-900. https://www.cnki.com.cn/Article/CJFDTOTAL-GGWS202006044.htm YU Q Y, LU Y, GAO S, et al. Analysis on epidemiological characteristics and influencing factors of influenza-like illness outbreaks in schools in Jinan City[J]. Chin J Public Health Manage, 2020, 36(6): 897-900. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GGWS202006044.htm