天津市传染性非典型肺炎流行特点及主要控制措施效果评价

王撷秀; 冯洪友; 刘东; 张之伦; 单爱兰; 朱向军; 高志刚; 王栩冬; 夏英毅; 陈茜

Abstract

王撷秀,冯洪友,刘东,张之伦,单爱兰,朱向军,高志刚,王栩冬,夏英毅,陈茜.天津市传染性非典型肺炎流行特点及主要控制措施效果评价[J].Chinese journal of Epidemiology,2003,24(7):565-569

天津市传染性非典型肺炎流行特点及主要控制措施效果评价

Epidemiological characteristics of severe acute respiratory syndrome in effectiveness on measures of control

Received:June 10, 2003

DOI：

KeyWord: 严重急性呼吸综合征流行病学爆发性流行

English Key Word: Severe acute respiratory syndrome Epidemiology Outbreak

FundProject:

Author Name	Affiliation
Wang Jiexiu	Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
Fang Hongyou	Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
Liu Dong	Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
Zhang Zhilun	Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
Shan Ailan	Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
Zhu Xiangjun	Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
Gao Zhigang	Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
Wang Xudong	Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
Xia Yingyi	Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
Chen Qian	Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China

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Abstract:

目的　分析天津市传染性非典型肺炎[严重急性呼吸综合征(SARS)]流行病学特征,对主要控制措施的效果进行初步评价.方法采用自行设计的病例报告表,全市统一的流行病学个案调查表及病例接触者、密切接触者树状分布图,深入病房、家庭、社区、团体等对病例及接触者进行调查.结果　以发病时间计算,自2003年4月13日至5月8日,包括输入病例在内发病175例,发病率为1.910万,其中死亡14例,病死率达8.0%.整个流行过程不足1个月,流行特点:1例"超级传播者"直接或间接传染了全市94.3%的病例;呈现以A、B、C 3家医院聚集发病为特点的爆发性流行,占全市病例的68.6%,3家医院外的家庭聚集发病占全市病例的14.3%,同事间传播为2.3%,散发者为9.1%,这些散发者未造成接触者感染;早期医务人员发病较多,占总病例数的38.2%,流行全过程参加SARS救治工作的1975名医护人员的总感染率为3.4%;全部流行过程传染源明确,传染链清晰,全市仅 3例患者未找到传染源,占病例总数的2%;在10例源头病例中仅"超级传播者"和另一病例传染了其接触者,其他传染源由于及时隔离未造成任何传播.结论　SARS是严重急性呼吸系统传染病,如能及时准确地掌握传染链并进行范围适染病适当、及时有效的封闭及隔离措施,以科学的方法提高全民的警觉度,传染链可能在较短时间内被切断,从而控制传播.

English Abstract:

Objective To analyze the epidemiologic characteristics of severe acute respiratory syndrome(SARS) and to evaluate the effect-iveness on its major control measures in Tianjn.Methods Adopting two case reports 1 and 2,designed by the Tianjin Centers for Disease Control and Prevention to develop a unified case-tracing table including the map of the distribution of close contacts to SARS patients. With those methods investigation on patients and their close contacts at hospital wards families communities and institu-tions of the patients were carried out.Results From April 13 through May 8 2003 there were 175 SARS cases including imported ones were identified with an incidence rate of 1.9 cases per 100000.Among them 14 died with a fatality of 8.0.The whole process of ep-idemic in Tianjin was less than one month with the following features:(1)93.7% of the total SARS cases in Tianjin were directly or ind-irectly transmitted by a super-spreader.(2)68.6 % of the total SARS patients were concentrated in 3 hospitals A} B and C which was me-nifastated in‘clustering'.Through study on the rest of the SARS patients results showed that 16. 8%of them were tramsmitted through family close contact and 2.3%due to contact to colleagues.However 12.6%of the patients were not able to show evidence that they had a-ny contact to a diagnosed SARS patient. At the early stage of the epidemic a number of medical practioners were infected taking up 38. 2% of the total SARS cases. Among the total number of 1975 medical workers who participated in the SARS medical cares and treatm-ents 3.4%of them got infected. During the outbreak all index cases and chains of transmission seemed to be dear with only 3 patients not abl-e to be traced for the source of infection taking up 2% of the total SARS patients in Tianjin. Among the 10 index cases only the super spreader and another one index case transmitted the virus to their contacts but the rest of index cases did not cause any seco-ndary infection.Conclusion Though SARS is clinically severe and can be spreaded quickly the epidemic can be under control with-in a short period of time if chains of SARS transmission are broken down and effective measures as isolation and quarantine against pa-tients as wdl as underscoring awareness among the publics in a scientific way being carried out.

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