2017年深圳市宝安区一起人星状病毒引起的急性胃肠炎暴发疫情调查

陈亿雄; 罗莉; 冉陆; 连怡遥; 高志勇; 刘娜; 靳淼; 李苑

doi:10.3784/j.issn.1003-9961.2020.05.018

2017年深圳市宝安区一起人星状病毒引起的急性胃肠炎暴发疫情调查

An acute gastroenteritis outbreak caused by human astrovirus in Bao'an district of Shenzhen, 2017

摘要

摘要:
目的探讨2017年深圳市宝安区一起学校急性胃肠炎暴发疫情的病原体和传播危险因素。
方法2017年10 — 11月，按照定义搜索深圳市宝安区某学校一起急性胃肠炎暴发疫情病例，采用描述性流行病学方法进行分析，并选择罹患率较高的5个班级作为调查对象，采用回顾性队列研究方法，调查269名学生的病例接触史、就餐、饮水习惯等暴露情况，用logistic回归分析其流行因素。采集患者的粪便或肛拭子，以及直饮机水、桶装水、厕所洗手水等水样，运用试剂盒检测病毒核酸。
结果2017年10月20日至11月17日，共搜集病例98例，总罹患率为3.21%（98/3 052），男、女性罹患率分别为3.59%（61/1 698）和2.73%（37/1 354），差异无统计学意义（χ²＝1.782，P＝0.181）。第三教学楼学生罹患率最高，为3.94%（6/152），其次是主教学楼学生，罹患率为3.62%（84/2 319）。各教学楼学生罹患率差异有统计学意义（χ²＝7.837，P＝0.049），主教学楼不同楼层学生罹患率的差异无统计学意义（χ²＝1.861，P＝0.713）。回顾性队列研究共调查269人，饮直饮水（RR＝6.975，95% CI：1.871～26.027）和接触病例（RR＝6.514，95% CI：2.314～18.358）是危险因素。粪便和肛拭子样本星状病毒核酸检测总阳性率为28.00%（7/25），水样本均阴性。
结论结合现场流行病学调查和实验室检测结果，判断为一起主要通过接触传播引起的人星状病毒感染暴发疫情，建议学校早发现、早隔离、早报告，尽可能减少健康学生接触病例。

Abstract:
ObjectiveTo explore the pathogens and transmission risk factors of an acute gastroenteritis outbreak occurred in a school in Bao'an district, Shenzhen in 2017.
MethodsAccording to the case definition, cases were searched in the school from October to November 2017. Descriptive epidemiological method was used for data analysis. Five classes with high attack rates were selected as the target. A retrospective cohort study was conducted to investigate the possible risk factors in 269 students, including their exposure history, dining and drinking habits. The survey data were used for logistic regression analysis. Stool samples and anal swabs of some infected cases, water samples from drinking fountains, barrelled water samples, and toilet water samples were collected for the detections of rotavirus, astrovirus, adenovirus, norovirus, and sappovirus by fluorescence PCR.
ResultsA total of 98 cases were identified in the school from October 20 to November 17, 2017. The overall attack rate was 3.21% (98/3 052). The attack rate was 3.59% in boy students (61/1 698) and 2.73% in girl students (37/1 354), respectively. No significant difference was found between boys and girls (χ²＝1.782, P＝0.181). The highest attack rate (3.94%, 6/152) was reported in students in teaching building 3, followed by 3.62% (84/2 319) in students in main teaching building. Significant differences in attack rate were found in attack rates among the students in different teaching buildings (χ²＝7.837, P＝0.049). There was no significant differences in attack rate among students in classes on different floors of the main teaching building(χ²＝1.861, P＝0.713). In this study, 269 students were investigated. Results of the retrospective cohort study showed that direct drinking water (RR＝6.975, 95% CI: 1.871–26.027) and case contact (RR＝6.514, 95% CI: 2.314–18.358) were the risk factors of this outbreak. The overall human astrovirus positive rate of the stool samples and anal swabs was 28.00% (7/25). No human astrovirus was detected in water samples.
ConclusionThis outbreak of human astrovirus infection was mainly caused through contact transmission. It is recommended that schools conduct early detection, isolation, and reporting of communicable disease cases to minimize the exposure in healthy students.

HTML全文

参考文献(23)

施引文献

资源附件(1)