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目的探讨湖南省某福利院麻疹暴发主要特征及影响因素,分析暴发疫情的传播特点。方法以一起发生在湖南省某福利院麻疹暴发为研究现场,采用回顾性调查的方法,用统一的调查表,通过现场调查的方法对福利院护理人员进行问卷调查。用传播链示意图分析传播关系。结果此次暴发疫情中麻疹确诊病例13例,均为福利院收养儿童,儿童罹患率为11.40%,首发病例发病前13 d曾到医院就诊。该福利院儿童麻疹类疫苗1剂次接种率42.45%(45/106),麻疹类疫苗2剂次接种率15.22%(14/92)。麻疹暴发影响因素的多因素分析结果显示随着与麻疹病例接触时间的增加,患麻疹的风险逐渐增加(OR=4.881,95%CI:1.871~12.735)。结论全部麻疹病例在发病前均与前代病例有密切接触史,生活中的密切接触、医源性感染是本起暴发疫情的主要传播因素。提高麻疹类疫苗接种率、加强医疗机构院内感染控制是控制麻疹暴发疫情的关键。
Objective To explore the main characteristics and influencing factors of measles outbreak in a welfare hospital in Hunan Province and analyze the characteristics of the spread of the outbreak. Methods The measles outbreak occurred in a welfare hospital in Hunan Province as the research site. A retrospective survey method was used to conduct a questionnaire survey on the nursing staff in the welfare center by a unified questionnaire and on-the-spot investigation. Use propagation chain diagram to analyze communication relationship. Results In the outbreak, 13 cases of measles were confirmed, all of them were adopted children in the Welfare Institute. The attack rate was 11.40%. The first case was admitted to the hospital 13 days before the onset of the outbreak. The welfare hospital children measles vaccine 1 dose 42.45% (45/106), measles vaccine 2 doses 15.22% (14/92). The results of multivariate analysis of the influencing factors of measles outbreak showed that the risk of measles increased with the increasing contact time with measles (OR = 4.881, 95% CI: 1.871-12.735). Conclusion All cases of measles were closely contacted with previous cases before the onset of illness. Close contact in life and iatrogenic infection were the main transmission factors of the outbreak. Raising the measles vaccination rate and strengthening the control of nosocomial infections in medical institutions are the keys to controlling the outbreak of measles.