AIRBORNE SPREAD OF MEASLES IN A SUBURBAN ELEMENTARY-SCHOOL
AIRBORNE SPREAD OF MEASLES IN A SUBURBAN ELEMENTARY-SCHOOL
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DOI：
10.1093/oxfordjournals.aje.a112560
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发表时间：
1978-01-01
影响因子：
5
通讯作者：
RILEY, RL
中科院分区：
文献类型：
--
作者：
RILEY, EC;MURPHY, G;RILEY, RL
本文对1974年春季发生在美国纽约郊区一所现代化小学的麻疹流行进行了分析，并建立了一个模型，用以计算同室同学、通风系统空气微生物和校车暴露的感染机会。这一流行病之所以引人注目，是因为它具有爆炸性，而且发生在一所97%的儿童都接种了疫苗的学校。许多人在不到1岁时接种了疫苗。指示病例是一名二年级的女孩，她在14个不同的教室里产生了28个继发病例。通过通风系统再循环的生物体受到强烈影响。两代之后，60名儿童被感染，疫情消退。根据对主要物理和生物因素的估计，可以计算出该指示病例产生约93个单位的空气传播感染（量子）/分钟。流行模式表明，第二次感染的传染性降低了一个数量级。指示病例的异常传染性、许多儿童的免疫接种不足以及整个学校空气循环的高百分比可能是爆发的范围和严重性的原因。
A measles epidemic in a modern suburban elementary school in upstate New York, USA, in spring, 1974, is analyzed in terms of a model which provides a basis for apportioning the chance of infection from classmates sharing the same home room, from airborne organisms recirculated by the ventilating system and from exposure in school buses. The epidemic was notable because of its explosive nature and its occurrence in a school where 97% of the children were vaccinated. Many were vaccinated at less than 1 yr of age. The index case was a girl in 2nd grade who produced 28 secondary cases in 14 different classrooms. Organisms recirculated by the ventilating system were strongly implicated. After 2 subsequent generations, 60 children were infected, and the epidemic subsided. From estimates of major physical and biologic factors, it was possible to calculate that the index case produced approximately 93 units of airborne infection (quanta)/min. The epidemic pattern suggested that the secondaries were less infectious by an order of magnitude. The exceptional infectiousness of the index case, inadequate immunization of many of the children and the high percentage of air recirculated throughout the school may account for the extent and sharpness of the outbreak.