苏通, 刘莹莹, 赵文娜, 于秋丽, 谢赟, 齐顺祥, 李琦. 一起诺如病毒胃肠炎暴发疫情的流行病学调查[J]. 疾病监测, 2020, 35(4): 362-366. DOI: 10.3784/j.issn.1003-9961.2020.04.018
引用本文: 苏通, 刘莹莹, 赵文娜, 于秋丽, 谢赟, 齐顺祥, 李琦. 一起诺如病毒胃肠炎暴发疫情的流行病学调查[J]. 疾病监测, 2020, 35(4): 362-366. DOI: 10.3784/j.issn.1003-9961.2020.04.018
Tong Su, Yingying Liu, Wenna Zhao, Qiuli Yu, Yun Xie, Shunxiang Qi, Qi Li. Epidemiological investigation of an outbreak of norovirus-caused gastroenteritis[J]. Disease Surveillance, 2020, 35(4): 362-366. DOI: 10.3784/j.issn.1003-9961.2020.04.018
Citation: Tong Su, Yingying Liu, Wenna Zhao, Qiuli Yu, Yun Xie, Shunxiang Qi, Qi Li. Epidemiological investigation of an outbreak of norovirus-caused gastroenteritis[J]. Disease Surveillance, 2020, 35(4): 362-366. DOI: 10.3784/j.issn.1003-9961.2020.04.018

一起诺如病毒胃肠炎暴发疫情的流行病学调查

Epidemiological investigation of an outbreak of norovirus-caused gastroenteritis

  • 摘要:
    目的了解2018年河北省一起诺如病毒暴发疫情的流行特点及暴发原因,探讨疫情处置经验。
    方法采用现场流行病学方法,收集2018年河北省一起疫情发生学校的基本情况,搜索病例并进行回顾性问卷调查,描述疾病流行特征,开展病例对照研究及危险因素探索,同时采集患者粪便或肛拭子、食物和水等环境标本进行肠道病毒及肠道致病菌的检测。
    结果本次疫情持续6 d,累计发病55例,涉及16个班级,罹患率为1.60%。 其中男性34例,女性21例,男女性别比为1.62∶1,年龄为6~37岁,平均年龄9.13岁。 患者症状以呕吐(92.73%)、腹泻(65.45%)为主,无重症死亡病例,病程1~2 d。 危险因素调查显示,高发病班级与无病例班级学生饮食及饮水构成比差异无统计学意义。 本次调查共采集病例标本19份,11份标本GⅡ组诺如病毒阳性,1份标本星状病毒阳性。 采集食品及水样本41份,检测肠道病毒均阴性,细菌学指标亦在正常范围内。
    结论该起暴发疫情由GⅡ组诺如病毒感染引起,人–人接触或呕吐物形成的气溶胶传播在疫情中起关键作用,首发病例发现、隔离不及时及呕吐物处理消毒不规范是导致疫情扩展蔓延并最终暴发的促发因素。

     

    Abstract:
    ObjectiveTo study the epidemiological characteristics and identify the cause of an outbreak caused by norovirus infection in a school in Hebei province in 2018, and evaluate the performance of the epidemic response.
    MethodsField epidemiology method were used to collect basic information of an outbreak in a school in Hebei province in 2018 and retrospective questionnaire survey was conducted for all cases, followed by descriptive analysis of the outbreak. Risk factors related to the outbreak were explored through cross-sectional and case-control study. Meanwhile, laboratory tests of enteroviruses and bacterial pathogens were performed by using stool samples and anal swabs of the patients, food and water samples, and environment samples.
    ResultsThe outbreak lasted for 6 days, involving 55 cases. The cases mainly occurred in 16 classes, and the attack rate was 1.60%. Among the cases, 34 were males, and 21 were females, with the ratio of 1.62∶1. The age of the cases ranged from 6 years to 37 years, with the average age of 9.13 years. The main clinical symptoms were vomiting (92.73%, 51/55), diarrhea (65.45%, 36/55), which all disappeared within 1 or 2 days after onset. No death and server case occurred. Risk factor analysis showed that the differences in food intake and water drinking were not significant between class with high attack rate and class without case. A total of 19 samples of the cases were collected, in which 11 were positive for norovirus GⅡand 1 was positive for astrovirus. In addition, in 41 samples of food and water, no enterovirus was detected and the bacterial indexes were also within normal range.
    ConclusionThe outbreak was caused by norovirus GⅡ. Vomit aerosol transmission and person to person contact were main transmission routes in this outbreak. Untimely discovery and isolation of the first case, improper dispose of vomit and disinfection were the facilitating factors for the disease spread and outbreak.

     

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