一起医院内急性出血性结膜炎暴发的现场流行病学调查
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刘晓峰

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R181.3+2R777.31

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Field epidemiological investigation on an outbreak of acute hemorrhagic conjunctivitis in a hospital
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    摘要:

    目的调查深圳市S医院疑似急性出血性结膜炎暴发的危险传播因素,为及时控制疫情提供科学依据。方法按照病例定义开展病例搜索,描述疾病三间分布,结合现场流行病学调查方法,形成假设,采用病例对照研究,比较病例组与对照组之间使用科室公用厕所、使用公用水龙头洗脸或洗手、揉眼习惯等可能危险因素差异。结果2011年6月7—15日,S医院共发现急性出血性结膜炎病例11例,所有病例均发生在W科住院部,罹患率为6.01%(11/183)。主要临床表现为眼部结膜充血(100.00%)、刺痛(81.82%)、异物感(72.73%)等。病程中位数为6 d(范围:3~11 d),无并发症发生。住走廊床位的患者罹患率为13.24%(9/68),明显高于住病房内患者的罹患率2.70%(2/74),差异有统计学意义(χ2=5.50,P=0.02)。“使用公用厕所”(OR=12.21,95% CI:1.28~288.33)、 “使用公用洗手池”(OR=12.21,95% CI:1.28~288.33)和“揉眼睛”(OR=6.22,95% CI:1.08~39.96)是危险因素;对揉眼睛习惯“经常或有时”、“偶尔”、“从不”进行分析,发现发病风险随揉眼睛频次的增加而升高(Liner trend χ2=5.54,P=0.02)。结论结合病例临床表现和相关流行病学资料提示,这是一起急性出血性结膜炎暴发疫情。在短时间内无法改善硬件设施的情况下,建议S医院加强对公共厕所、水龙头等公共场所物体表面的消毒工作,教育患者不用手直接揉眼睛;同时建议政府进一步加大对医疗卫生机构病床建设的投入。

    Abstract:

    ObjectiveTo investigate the risk factors of transmission of suspected acute hemorrhagic conjunctivitis(AHC) in the S hospital of Shenzhen city, and provide a scientific basis for timely control of the epidemic.MethodsCases were searched according to the definition of AHC, and distribution of space,time and population were described; hypothesis were put forward based on field epidemiological investigation; casecontrol study was adopted to compare the difference in the possible risk factors between case and control groups.ResultsFrom June 7 to June 15, 2011, 11 AHC cases were found in W inpatient department of the S hospital. The attack rate was 6.01%(11/183), and the major clinical manifestations were conjunctival congestion(100.00%), tingling(81.82%), and foreign body sensation(72.73%). The median of disease course was 6 days (3-11days). No complication was found.The attack rate of patients living in corridor beds was significantly higher than that of patients living inside the ward room (13.24% [9 / 68] vs 2.70% [2 / 74], χ2=5.50,P=0.02). Using a public toilet (OR=12.21,95% CI:1.28-288.33), using a public lavatory (OR=12.21,95% CI:1.28-288.33) and rubbing eyes (OR=6.22, 95% CI:1.08-39.96) were risk factors; analysis on habit of rubbing the eyes “often or sometimes”, “occasionally”, “never” showed that the risk of developing AHC increased with increasing frequency of rubbing eyes(Liner trend χ2=5.54,P=0.02).ConclusionClinical manifestations and epidemiological data suggest that this is an outbreak of AHC. S hospital is suggested to strengthen disinfection of the public toilets, faucets and other public places, and patients are suggested not to rub eyes directly by hand; government are suggested to increase investment in the beds construction of medical and health institutions.

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李苑,刘晓峰,吴泰顺,等.一起医院内急性出血性结膜炎暴发的现场流行病学调查[J]. 中国感染控制杂志,2012,11(4):252-256.
LI Yuan, LIU Xiaofeng, WU Taishun, et al. Field epidemiological investigation on an outbreak of acute hemorrhagic conjunctivitis in a hospital[J]. Chin J Infect Control, 2012,11(4):252-256.

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  • 收稿日期:2012-01-31
  • 最后修改日期:2012-03-12
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  • 在线发布日期: 2012-09-30
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