摘要
目的 对一起公共场所传染性非典型肺炎 (SARS)暴发的流行状况和因素进行调查分析 ,为制定预防控制措施提供依据。方法 用统一的个案调查表对一起公共场所聚餐所致的SARS暴发病例及相关的所有病例进行调查 ,采集部分病例咽漱液、血清分别用荧光定量PCR测定SARS抗原和用ELISA测定SARSIgG、IgM。结果 2 0 0 3年 2月 2 1～ 2 8日广州市芳村区某酒楼 9名就餐者聚餐后全部陆续发病 ,其中 1人死亡 ,所有病例临床表现符合卫生部SARS临床诊断标准。用荧光定量PCR测定 3例患者咽漱液 ,2例SARS冠状病毒阳性 ;用ELISA法测定 5例患者血清 ,3例SARS冠状病毒特异性IgG抗体阳性 ,1例 (指示病例 )IgM抗体阳性。本起暴发发生于通风不良小型餐厅包房内 ,聚餐者停留玩纸牌和进餐 ,时间长达 3h。首例患者于聚餐后次日 (2 1日 )发病 ,聚餐前多次到过SARS收治医院的呼吸病区看护患肿瘤的父亲 (父亲和曾去医院看护的另 2名亲属也分别在指示病例发病同日及 1 0d内发病 ) ,其余 8名聚餐者病前除这次聚餐外无其他明确的接触史或暴露史。病例发病潜伏期为 2～ 8d ,平均 5d。结论 证实本次暴发是因长时间在通风不良的公共场所聚会所导致的SARS暴发 ,主要传播途径可能为近距离的飞沫传播和密切接触传播 。
Objective To search for the determinants of the SARS outbreak in the public in order to assist to work out the control strategies accordingly.Methods The cases, who dined together in a restaurant, and their close contacts were interviewed with a uniform questionnaire. Throat washing and serum samples collected from some of the cases were tested for antigen or antibody (IgG and IgM) of corona virus through fluorescent quantitative polymerase chain reaction (PCR) with specific primers and ELISA respectively. Results Nine people came down with SARS during February 21 to 28, 2003 in succession after having dinner in a restaurant in Fangcun District, Guangzhou. One died later. Of the 3 samples of throat washing tested by PCR, two yielded positive results. Of the 5 serum samples tested by ELISA, 3 yielded positive results for specific IgG. IgM was also detected in serum from the index case. The incubation period was 2-8 days with a mean of 5 days. The outbreak took place in a small room of a restaurant with poor ventilation. The attendees had stayed there for enjoyment and dinner for three hours. The index case developed symptoms the next day. Before the party she often went to the Respiratory Department of a hospital, in which some SARS patients were treated, to look after her father who suffered from cancer. As to the other attendees, they did not have any exposure history to SARS other than the party. It indicated that the index case was the source of infection of this outbreak.Conclusion The outbreak was proved to be caused by close contact with SARS case for a long time in the poor ventilation place. The main transmission route might be close face to face contact with infected droplets. The cases at the end of incubation may have infectivity.
出处
《华南预防医学》
2003年第3期40-41,共2页
South China Journal of Preventive Medicine
