武汉市一起新冠确诊病例出院后家庭再现病例调查

马兰; 柳赟昊; 张玲; 谢淑云; 张雪峰; 吴晓旻

doi:10.16462/j.cnki.zhjbkz.2020.11.019

武汉市一起新冠确诊病例出院后家庭再现病例调查

doi: 10.16462/j.cnki.zhjbkz.2020.11.019

1.
430065武汉，环境卫生与职业医学系，武汉科技大学医学院公共卫生学院
2.
430024武汉，环境健康与食品卫生所，武汉市疾病预防控制中心
3.
210009 江苏省疾病预防控制中心
4.
310051 浙江省疾病预防控制中心

基金项目:

湖北省高等学校优秀中青年科技创新团队计划 T2020003

详细信息

通讯作者:
吴晓旻，E-mail：dennis_602@sina.com

中图分类号: R183.3; R563.1
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- 文章访问数: 396
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- PDF下载量: 34
- 被引次数: 0
出版历程
- 收稿日期: 2020-07-04
- 修回日期: 2020-09-08
- 刊出日期: 2020-11-10

Investigation of family reappear cases after discharge of a COVID-19 case in Wuhan City

1.
Department of Environmental Health and Occupational Medicine, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
2.
2Institute of Environmental Health and Food Hygiene, Wuhan Center for Disease Control and Prevention, Wuhan 430024, China
3.
Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu 210009, China
4.
Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang 310051, China

Funds:

Outstanding young and middle-aged technology innovation team project of Hubei Provincial Department of Education T2020003

More Information

Corresponding author: WU Xiao-min，E-mail：dennis_602@sina.com

摘要

摘要: 目的分析新型冠状病毒肺炎(COVID-19)确诊病例出院后家庭再现病例的流行病学特征，为家庭聚集性疫情防控提供依据。方法采用现场流行病学调查方法，收集疫情相关人员基本信息、暴露史、发病情况和临床诊疗资料等，分析家庭聚集性疫情感染来源和传播模式。结果本起家庭聚集性疫情中，有3名病例和1人核酸检测阳性。感染来源最大可能来自医院暴露，后续家庭内传播。首发病例C出院时可能未“痊愈”，家庭内再现病例的发病时间可能远早于其报告的“发病”时间，未发现支持出院后传播的证据。结论建议强化流行病学调查，并综合临床、实验室等结果进行综合研判，落实密切接触者集中隔离医学观察和病人家庭终末消毒。
- 新型冠状病毒肺炎 /
- 家庭聚集性 /
- 调查
Abstract: Objective To analyze the epidemiological characteristics of coronavirus disease 2019 (COVID-19) in a family cluster after a patient was discharged from hospital, and to provide recommendations for prevention and control of familial aggregation of COVID-19. Methods On-site epidemiological investigation was conducted to collect personal information, exposure history, morbidity, and clinical information of the COVID-19 patients and close contacts. Based on the data, the source of the COVID-19 virus and transmission mode were further analyzed. Results There were 3 cases and 1 person tested positive for nucleic acid of the virus in the familial aggregation of COVID-19 infection. The most likely source of infection came from hospital exposure and subsequent transmission among family members. Case C, as the first case, maybe a deceptive cure when she was discharged from hospital. The time of recurrence in the family might be much earlier than the reported time of symptom onset. No evidence was found to support the spread of COVID-19 after her discharge. Conclusions It is recommended to strengthen epidemiological investigation, comprehensively analyze clinical and laboratory results, quarantine close contacts of COVID-19 confirmed cases for medical observation, and carry out terminal disinfection of patients' households.
- COVID-19 /
- Family Cluster /
- Investigation

HTML全文

图 1 武汉市一起新冠肺炎聚集性疫情中病例及无症状感染者关系图

Figure 1. Relationship between cases and asymptomatic infected persons in a cluster of new crown pneumonia in Wuhan

下载: 全尺寸图片幻灯片

图 2 武汉市一起新冠肺炎家庭聚集性疫情时序图

Figure 2. Sequence diagram of a family clustering epidemic of COVID-19 in Wuhan

下载: 全尺寸图片幻灯片

表 1 武汉市一起家庭聚集性疫情的家庭成员基本情况

Table 1. Basic information of family members with a family cluster epidemic in Wuhan

病例类别	性别	年龄(岁)	既往病史	发病时间	首诊时间	确诊时间
病例A	男	79	脑梗塞	2月10日	2月11日	2月17日
病例B	女	75	白内障、糖尿病	约为2月2日	3月7日	3月8日
首发病例C	女	54	无	1月26日	1月26日	2月8日
无症状感染者D	男	59	糖尿病	—	—	2月18日

下载: 导出CSV

表 2 武汉市一起家庭聚集性疫情确诊病例的症状与体征

Table 2. Symptoms and signs of a confirmed case of a family cluster epidemic in Wuhan

症状与体征	体温(最高)	咳嗽	乏力	呼吸困难	纳差	肺毛玻璃阴影
病例C	有发热	-	-	+	-	+
病例A	38℃以上	-	+	-	+	+
病例B	39℃以上	+	+	+	+	-

下载: 导出CSV

参考文献(13)

[1]	World Health Organization. Coronavirus disease (COVID-2019) situation reports[EB/OL]. (2020-06-22)[2020-06-24]. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200622-covid-19-sitrep-154.pdf?sfvrsn=d0249d8d_2.
[2]	Ye F, Xu S, Rong Z, et al. Delivery of infection from asymptomatic carriers of COVID-19 in a familial cluster[J]. Int J Infect Dis, 2020, 94:133-138. DOI: 10.1016/j.ijid.2020.03.042.
[3]	Li C, Ji F, Wang L, et al. Asymptomatic and human-to-human transmission of SARS-CoV-2 in a 2-family custer, Xuzhou, China[J]. Emerg Infect Dis, 2020, 26(7):1626-1628. DOI: 10.3201/eid2607.200718.
[4]	孙永, 何军, 蔡芬, 等.新型冠状病毒IgG/IgM抗体双重检测免疫层析方法的建立研究[J].合肥工业大学学报(自然科学版), 2020, 43(5):700-705. DOI:10.3969/j.issn.1003-5060. 2020.05.021. Sun Y, He J, Cai F, et al. Establishment of a new detection immunochromatography method for novel coronavirus IgG/IgM antibodies[J]. Journal of Hefei University of Technology (Natural Science Edition), 2020, 43(5): 700-705. DOI: 10.3969/j.issn.1003-5060.2020.05.021.
[5]	Backer JA, Klinkenberg D, Wallinga J. Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travellers from Wuhan, China, 20-28 January 2020[J]. Euro Surveill, 2020, 25:2000062. DOI: 10.2807/1560-7917.ES.2020.25.5.2000062
[6]	Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster[J]. Lancet, 2020, 395:514-523. DOI: 10.1016/S0140-6736(20)30154-9.
[7]	Wang XL, Pan Y, Zhang DT, et al. Basic epidemiological parameter values from data of real-world in mega-cities: the characteristics of COVID-19 in Beijing, China[J]. BMC Infect Dis, 2020, 20(1):526. DOI: 10.1186/s12879-020-05251-9.
[8]	刘志荣, 苏斌, 吴家兵, 等.一起新型冠状病毒肺炎聚集性疫情调查[J].中华疾病控制杂志, 2020, 24(5):512-515, 522. DOI: 10.16462/j.cnki.zhjbkz.2020.05.004. Liu ZR, Su B, Wu JB, et al. An investigation of a coronavirus disease 2019 (COVID-19) cluster epidemic[J]. Chin J Dis Prev Control, 2020, 24(5):512-515, 522. DOI: 10.16462/j.cnki.zhjbkz.2020.05.004.
[9]	Huang K, Zhang J, Wu W, et al. A retrospective analysis of the epidemiology, clinical manifestations, and imaging characteristics of familial cluster-onset COVID-19[J]. Ann Transl Med, 2020, 8(12):747. DOI: 10.21037/atm-20-3759.
[10]	解立新, 肖坤.老年新型冠状病毒肺炎临床救治相关问题[J].中华保健医学杂志, 2020, 22(2):110-112. DOI: 10.3969/j.issn.1674-3245.2020.02.002. Xie LX, Xiao K. Problems related to the clinical treatment of coronavirus disease 2019 (COVID-19) in the elderly[J]. Chinese Journal of Health Care, 2020, 22(2):110-112. DOI:10.3969/j.issn.1674-3245.2020. 02.002.
[11]	北京市卫生健康委员会.北京昨日新增报告13例新冠肺炎确诊病例[EB/OL]. (2020-06-23)[2020-09-03]. http://wjw.beijing.gov.cn/wjwh/ztzl/xxgzbd/gzbdyqtb/202006/t20200623_1930586.html. Beijing Municipal Health Commission. Beijing newly reported 13 newly diagnosed cases of coronavirus disease 2019 (COVID-19)[EB/OL]. (2020-06-23)[2020-09-03]. http://wjw.beijing.gov.cn/wjwh/ztzl/xxgzbd/gzbdyqtb/202006/t20200623_1930586.html.
[12]	张威, 田思佳, 王颖, 等.新冠肺炎家庭聚集性病例分析[J].中华急诊医学杂志, 2020, (4):511-512. DOI: 10.3760/cma.j.issn.1671-0282.2020022.002. Zhang W, Tian SJ, Wang Y, et al. Analysis of family aggregation cases of coronavirus disease 2019 (COVID-19)[J]. Chinese Journal of Emergency Medicine, 2020, (4):511-512. DOI:10.3760/cma.j.issn.1671- 0282.2020022.002.
[13]	国家卫生健康委办公厅.关于印发新型冠状病毒肺炎诊疗方案(试行第八版)的通知[EB/OL]. (2020-08-19)[2020-09-03]. http://www.nhc.gov.cn/yzygj/s7653p/202008/0a7bdf12bd4b46e5bd28ca7f9a7f5e5a.shtml. The General Office of the National Health Commission. Notice on the issuance of coronavirus disease 2019 (COVID-19) diagnosis and treatment plan (for trial implementation of the eighth edition)[EB/OL]. (2020-03-04)[2020-09-03]. http://www.nhc.gov.cn/yzygj/s7653p/202008/0a7bdf12bd4b46e5bd28ca7f9a7f5e5a.shtml.