2020年上海市一起洗浴中心庞蒂亚克热暴发调查
A Pontiac fever outbreak associated with exposure to a bath center in Shanghai city in 2020:a survey report
俞晓 1崔鹏 1陈敏 2陈明亮 2韩若冰 1孔德川 1邱琪 1刘清 3潘浩1
作者信息
- 1. 上海市疾病预防控制中心传染病防治所急性传染病防治科,上海 200336
- 2. 上海市疾病预防控制中心病原生物检定所,上海 200336
- 3. 上海市奉贤区疾病预防控制中心传染病防制科,上海 201499
- 折叠
摘要
目的 报告2020年上海市发生的一起洗浴中心庞蒂亚克热暴发疫情的流行病学调查结果,以期为后续同类疫情的监测和调查处置提供参考.方法 对上海市奉贤区发热门诊2020年12月18-21日具有某洗浴中心暴露史的139例发热病例进行流行病学调查.以在该洗浴中心有明确轨迹和饮食信息的74例患者为病例组,以有该洗浴中心暴露史但未发热的44名健康人群作为对照组进行流行病学病因调查,采用logistic回归分析暴露危险因素,并使用RT-PCR方法对病例组15例发热患者深咳痰液样本进行病原核酸检测,利用BCYE平板进行军团菌培养.使用余氯检测仪现场检测该洗浴中心水中游离性余氯.结果 除发热外,139例病例出现频率最高的症状依次为乏力(71例,51.08％)、头痛(58例,41.73％)和肌痛(58例,41.73％),疫情潜伏期为12～68 h,M为36 h.病例对照研究中,单因素分析结果显示在该洗浴中心泡汤是发热的危险因素(OR=9.036,95％CI=3.521～23.189);多因素logistic回归结果分析显示曾在美肌汤池泡汤者的危险度是未泡者的5.456倍(95％CI=1.746～17.042).4例发热病例深咳痰液样本检出军团菌核酸阳性,4份环境样品培养出军团菌菌株,2个汤池余氯低于标准值(分别为0.2、0.09 mg/L).结论 结合流行病学、临床表现和实验室检测结果,综合判断此次疫情为一起由军团菌引起的庞蒂亚克热暴发.
Abstract
Objective To report a survey on an outbreak of Pontiac fever associated with history of exposure to a bath center in Shanghai in 2020 for providing a reference to investigation of relevant epidemics.Methods A questionnaire survey was conducted among 139 cases of fever of unknown origin(all with the history of exposure to a bath center)reported by fever clinics during 18-21 December,2020 in Fengxian district of Shanghai.A subsequent case-control study was carried out among 74 cases with explicit information on activities in the bath center and 44 healthy controls ever exposed to the bath center during the same period.Deep throat sputum samples were collected from 15 cases for nucleic acid detections of multiple pathogens with reverse transcription-polymerase chain reaction(RT-PCR)and Legionella culture with buffered charcoal yeast-extract(BCYE)plate.Residual chlorine detector was used in field study to measure residual chlorine in water of various pools in the bath center.Logistic regression analysis was adopted to explore factors correlated with the incidence of the fever of unknown origin.Results The most common observed symptoms among the 139 fever cases were weakness(proportion:51.08％,case number:71),headache(41.73％,58),and myalgia(41.73％,58).The median incubation period for the symptom incidence was 36 hours,with an range of 12-68 hours.In the case-control study,univariate analysis revealed that bathing in pools of the bath center was a risk factor for fever incidence(odds ratio[OR]=9.036,95％confidence interval[95％CI]:3.521-23.189);multivariate logistic regression analysis also showed that the cases ever bathing in a special pool for body beatification was at a significantly increased risk of fever incidence(OR=5.456,95％CI:3.521-23.189).Legionella nucleic acid was detected in 4 cases.Legionella strains were cultured in 4 environment swab samples collected in the bath center.The residual chlorine of water in two of bathing pools(0.2 mg/L and 0.09 mg/L)were lower than that of the national standard.Conclusion Based on epidemiologic evidence,clinical symptom of the cases,and laboratory test results,the outbreak of fever of unknown origin was a Pontiac fever caused by Legionella associated with the exposure to a bath center.
关键词
不明原因发热/庞蒂亚克热/军团菌/暴发/洗浴中心/上海Key words
fever of unknown origin/Pontiac fever/Legionella/outbreak/bath center/Shanghai city引用本文复制引用
基金项目
科技部科技创新2030-"新一代人工智能"重大项目(2021ZD0114005)
上海市疾病预防控制青年骨干人才培养项目(22QNGG09)
出版年
2024
NETL
NSTL
万方数据