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目的通过对无锡市某医院内的一起麻疹暴发疫情调查分析,了解麻疹的流行特征,为科学防控麻疹提供依据。方法对2015年无锡市某医院的麻疹暴发疫情流行病学特征进行分析。结果麻疹确诊病例7例,男性3例,女性4例,男女性别比1∶1.33,病例均为医院门诊部医务人员;年龄集中在20~45岁;主要症状为发热和出疹,实验室检测荧光PCR法麻疹病毒核酸阳性5例,麻疹血清抗体阳性1例,两者均阳性为1例;麻疹接种史不详6例,占发病总数的85.71%,部分病例有发热病例接触史,医务人员口罩配戴率低,医院通风不良,麻疹应急接种1 246人,应急接种率达90%以上。结论医务人员麻疹免疫覆盖面不够、医院麻疹监测工作不到位、院内感染防控不到位是本起疫情暴发的主要原因,消除麻疹的有效措施应从规范设置发热门诊,提高麻疹监测敏感性,严格控制院内感染,提高医务工作人员麻疹免疫水平入手。
Objective To understand the epidemiological characteristics of measles through a survey and analysis of an outbreak of measles in a hospital in Wuxi City and provide a basis for scientific prevention and control of measles. Methods The epidemiological characteristics of measles outbreak in a hospital in Wuxi in 2015 were analyzed. Results Seven cases of measles were diagnosed, including 3 males and 4 females, with a male-female ratio of 1: 1.33. The cases were all medical staffs in the outpatient department of the hospital. The age ranged from 20 to 45 years old. The main symptoms were fever and rash, laboratory tests Fluorescent PCR method measles virus nucleic acid positive in 5 cases, measles serum antibody positive in 1 case, both were positive in 1 case; measles history of unknown 6 cases, accounting for 85.71% of the total number of cases, some cases of fever history of exposure, medical masks Wearing rate is low, hospital ventilation is poor, emergency vaccination of 1 246 people measles, emergency vaccination rate of more than 90%. Conclusion The coverage of measles in medical staff is not enough, the monitoring of measles in hospital is not in place, and the inadequate prevention and control of nosocomial infection are the main reasons for the outbreak of measles. Effective measures to eliminate measles should be from the setting of fever clinics to improve the sensitivity of measles surveillance and strictly control the hospital Infection, improve the level of immunity of medical staff to start measles.