目的 通过分析铜陵市某高校肺结核聚集性疫情,探讨学校肺结核疫情发生的风险。方法 应用现场流行病学方法,开展病例搜索,对病例之间的流行病学关联性进行分析,追溯传染源。结果 共搜索到15例学生结核病例,其中9例存在流行病学关联,为聚集性疫情;首发病例痰涂片未阴转的情况下返校复课,是聚集性病例发生的重要原因;高暴露等级的密切接触者结核菌素(PPD)试验强阳性率61.02%,中等暴露密切接触者PPD强阳性率17.02%,高暴露密切接触者患者检出率13.56%,中等暴露密切接触者没有发现患者;首次暴露的密切接触者中,PPD强阳性组肺结核续发率是PPD非强阳性组的1.95倍。结论 传染源未得到有效管理是本次聚集性疫情发生的主要原因,做好传染源的管理及结核菌感染者的预防性治疗是防控学校结核病疫情的关键措施。

Objective Through the analysis of a tuberculosis cluster epidemic in a university in Tongling City,the risk of tuberculosis epidemic in schools was discussed. Methods Using field epidemiological methods to conduct case search, analyze epidemiological correlation between cases and trace the source of infection. Results A total of 15 cases of tuberculosis among students were searched, of which 9 cases were epidemiologically related and were clustered epidemics. The first case returned to school without negative sputum smear was an important cause of clustered cases. The strong positive rate of tuberculin (PPD) test was 61.02% in close contacts with high exposure level,17.02% in close contacts with moderate exposure level. The detection rate of pulmonary tuberculosis in people with high exposure was 13.56%. No patients were found in close contacts with moderate exposure. Among the first-time exposed close contacts, the recurrence rate of pulmonary tuberculosis in strongly positive PPD group was 1.95 times higher than that in non-strongly positive PPD group. Conclusion The main reason for this clustered epidemic is that the source of infection has not been effectively managed. The key measures to prevent and control the epidemic of tuberculosis in schools are to manage the source of infection and to take preventive treatment on tuberculosis infected persons.