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目的查明吉林省某医院2015年2月发生的一起麻疹暴发疫情的传播链以及暴发原因,为麻疹医院院内感染防控措施的制定提供依据。方法对所有疑似麻疹病例进行流行病学个案调查,采用描述流行病学方法进行分析;采用酶联免疫吸附试验(ELISA)检测麻疹Ig M抗体;采用逆转录-聚合酶链反应(RT-PCR)法检测麻疹病毒核酸;利用生物信息学软件对麻疹病毒序列进行分析。结果该起疫情共发生7例麻疹确诊病例,其中4例为医护人员、3例为患者;首例病例为门诊患者,二代病例有4例,三代病例有2例;3例病例获得麻疹病毒核蛋白基因序列数据,并证实为H1a基因亚型麻疹病毒,核蛋白基因同源性为99.7%~100%。结论本起疫情是通过医院内传播引起的麻疹暴发,由H1a基因型麻疹病毒引起。应加强麻疹院内感染的及时发现、报告和处置,以及对医务人员的疫苗接种和培训工作。
Objective To identify the transmission chain of an outbreak of measles that occurred in a hospital in Jilin Province in February 2015 and the causes of the outbreak, and provide evidence for the prevention and control measures of nosocomial infection in measles hospitals. Methods Epidemiological investigation of all cases of suspected measles was conducted and the descriptive epidemiological method was used for the analysis. IgM antibody of measles was detected by enzyme-linked immunosorbent assay (ELISA) and RT-PCR Method to detect measles virus nucleic acid; using the bioinformatics software to analyze the measles virus sequence. Results A total of 7 confirmed cases of measles were detected in this outbreak, of which 4 were health care workers and 3 were patients. The first case was outpatient, with 4 cases in the second generation and 2 cases in the third generation, and 3 cases were measles virus Nucleoprotein gene sequence data, and confirmed as H1a subtype measles virus, nucleoprotein gene homology of 99.7% to 100%. Conclusion The outbreak was caused by measles virus H1a due to transmission of measles through the hospital. Timely detection, reporting and disposal of measles nosocomial infections should be strengthened as well as vaccination and training of medical staff.