目的 通过调查和分析霍山县一起学校结核病聚集性疫情,探讨学校结核病聚集性疫情发生的原因,为改进霍山县学校结核病防控工作提供依据。方法 通过现场流行病学方法,对指示病例的密切接触者进行筛查,并对相关资料进行分析。结果 共筛查出3例学生结核病患者,其中2例与指示病例有明显的流行病学关联,判定为一起聚集性疫情;指示病例是首发病例;首发病例所在班级(高三18班)结核菌素纯蛋白衍生物 (Purified Protein Derivative of Tuberculin,PPD )皮肤试验强阳性率为26.1%,同一楼层相邻班级(高三16班)学生结核菌素皮肤试验强阳性率11.0%(7/66),两班PPD强阳性率比较,差异有统计学意义(χ²=5.358,P=0.021);首发病例所在班级男生PPD强阳性率为16.2%(6/37),女生PPD强阳性率37.5%(12/32),两者比较差异有统计学意义(χ²=4.031,P=0.045)。结论 首发病例传染性较强,没有早期发现是发生这次聚集性疫情的主要原因。做好首发病例的密切接触者预防性服药干预工作,可以阻断聚集性疫情的发生。

Objective Through the investigation and analysis of a school tuberculosis cluster epidemic in Huoshan County,the reasons for the school tuberculosis cluster epidemic were explored,and the basis for improving the prevention and control of tuberculosis in schools in Huoshan County was provided. Method Close contacts of the index case were screened by field epidemiological methods and the relevant data were analyzed. Results A total of 3 cases of students with tuberculosis were screened out,of which 2 cases had obvious epidemiological correlation with the index case and were identified as a cluster epidemic.The index case is the first case.The class of the first case (Class 18,senior 3) had a strong positive rate of 26.1% in the Purified Protein Derivative of Tuberculin (PPD) skin test.The strong positive rate of tuberculin skin test of students in adjacent classes on the same floor (Class 16,senior 3) was 11.0% (7 / 66).There was significant difference in the strong positive rate of PPD between the two classes(χ²=5.358,P=0.021).The PPD positive rate was 16.2% (6 / 37) in male students and 37.5% (12 / 32) in female students about the class of the first case,the difference was statistically significant(χ²=4.031,P=0.045). Conclusion The first case is infectious.Delays in detection were the main cause of the cluster outbreak.To do well the preventive medication intervention work of close contacts of the first case can block the occurrence of the cluster outbreak.