一起医务人员水痘暴发调查分析—一种少见的空气传播方式
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作者单位:

1.首都医科大学附属北京友谊医院疾病控制与预防感染管理处, 北京 100050;2.首都医科大学附属北京友谊医院重症医学科, 北京 100050

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周春莲  E-mial: 15811547910@163.com

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An outbreak of varicella in health care workers—a rare mode of air transmission
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Affiliation:

1.Department of Disease Prevention and Control-Infection Management, Beijing Friendship Hospital Capital Medical University, Beijing 100050, China;2.Department of Critical Care Medicine, Beijing Friendship Hospital Capital Medical University, Beijing 100050, China

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    摘要:

    目的 调查分析一起医务人员医院感染水痘暴发事件,分析水痘-带状疱疹病毒医院传播的原因。 方法 通过实地访谈、电话问询调查2020年10月5日—12月23日某院重症监护病房(ICU)医务人员人口统计学资料、水痘、带状疱疹相关流行病学史和疫苗接种史,并了解所有ICU住院患者水痘、带状疱疹发生情况及转归,分析其流行病学特征及传播途径。 结果 2020年10月26日—12月2日,ICU共报告4例医务人员感染水痘,暴发持续时间为38 d。罹患者均为ICU护理人员,其中本科室护士2例,实习学生1例,轮转护士1例;一代病例1例,二代病例2例,三代病例1例,所有病例均否认其共同居住人员及近期生活中接触水痘或带状疱疹病例。ICU于9月28日—10月20日曾收治1例64岁老年女性带状疱疹后神经痛患者,收治时患者右腰部散在带状疱疹已结痂;首发病例曾在未佩戴手套情况下护理过该患者。在感染病例出疹前72 h使用休息室1的易感者水痘感染率为66.7%,使用休息室2的易感者均未发生感染。此次水痘暴发事件共造成直接经济损失2 725元。 结论 首发病例可能是由于未佩戴手套情况下护理1例免疫功能不全的带状疱疹病例引起,续发病例可能是吸入感染病例使用休息室后呼吸道分泌物在室内形成较高浓度的病毒颗粒气溶胶引起的水痘暴发事件。

    Abstract:

    Objective To investigate and analyze an outbreak of healthcare-associated infection (HAI) with varicella among health care workers (HCWs), analyze the causes of hospital transmission of varicella zoster virus. Methods Through on-site interview and telephone inquiry, the demographic data, varicella and herpes zoster-rela-ted epidemiological history and vaccination history of HCWs in intensive care unit (ICU) of a hospital from October 5 to December 23, 2020 were investigated, the occurrence and prognosis of varicella and herpes zoster in all ICU patients were investigated, epidemiological characteristics and transmission route were analyzed. Results From October 26 to December 2, 2020, ICU reported 4 cases of varicella infection among HCWs, the outbreak lasted for 38 days. All infected HCWs were ICU nurses, including 2 nurses of ICU, 1 intern nurse and 1 rotation nurse; there are 1 case in the first generation, 2 cases in the second generation and 1 case in the third generation, all patients denied their co-habitation and recent exposure to varicella or herpes zoster cases. A 64-year-old female patient with post-herpetic neuralgia was hospitalized in ICU from September 28 to October 20, at the time of admission, the patient's right waist scattered herpes zoster had scabbed; the first case had cared for patient without wearing gloves. Infection rate of susceptible persons who used lounge-1 72 hours before the eruption of varicella was 66.7%, susceptible persons who used lounge-2 were not infected. This outbreak caused a total direct economic loss of 2 725 Yuan. Conclusion The first case may be caused by nursing a hypo-immunity case of herpes zoster without wearing gloves, and the subsequent case may be the outbreak of varicella caused by inhaling the high concentration of virus particle aerosol formed by respiratory secretions of infected cases in the lounge.

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郭青青,朱晨迪,李莹莹,等.一起医务人员水痘暴发调查分析—一种少见的空气传播方式[J]. 中国感染控制杂志,2021,(11):1051-1055. DOI:10.12138/j. issn.1671-9638.20211300.
Qing-qing GUO, Chen-di ZHU, Ying-ying LI, et al. An outbreak of varicella in health care workers—a rare mode of air transmission[J]. Chin J Infect Control, 2021,(11):1051-1055. DOI:10.12138/j. issn.1671-9638.20211300.

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  • 收稿日期:2021-04-02
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  • 在线发布日期: 2024-04-26
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