2023年北京市某公司一起由GⅡ型诺如病毒引起的急性胃肠炎暴发疫情调查

Investigation on an outbreak of acute gastroenteritis caused by norovirus G in a company in Beijing, 2023

  • 摘要:
    目的 调查和分析一起2023年北京市某公司由GⅡ型诺如病毒引起的暴发疫情,探讨其流行模式,为今后急性胃肠炎暴发疫情防控提供依据。
    方法 收集疫情发生公司的基本情况,主动搜索病例资料,运用描述性流行病学方法分析疫情特征,应用病例–对照研究分析暴发疫情的传播方式及危险因素。
    结果 发现病例21例,罹患率为5.77%(21/364)。 临床表现以腹泻为主(66.67%)、其次为呕吐(47.62%)、腹痛(19.05%)等症状。 共采集104份标本进行诺如病毒、札如病毒、轮状病毒、肠道腺病毒、星状病毒核酸检测,29份标本中检测出GⅡ型诺如病毒核酸阳性,阳性率为27.88%(29/104)。 病例分布具有空间聚集性,不同楼层工作人员罹患率差异有统计学意义(χ2=33.786,P<0.05);公司职员和食堂工作人员罹患率差异有统计学意义(χ2=29.217,P<0.05)。 4月25日在普通员工食堂吃午餐(比值比=4.50,95%置信区间:1.01~20.11)为患病的危险因素。
    结论 本次疫情为GⅡ型诺如病毒引起的一起暴发疫情,可能为某位食堂工作人员感染诺如病毒后未重视,带病上岗,导致食堂工作人员及来食堂就餐的公司工作人员被感染。 提示集体单位要落实主体责任,做好员工健康监测工作,避免员工带病上岗,并及时做好消毒工作。

     

    Abstract:
    Objective To investigate and analyze an outbreak of acute gastroenteritis caused by GⅡ norovirus in a company in Beijing, 2023, understand its epidemiological characteristics, and provide evidence for the prevention and control of acute gastroenteritis outbreaks in the future.
    Methods The basic information of the company where the outbreak occurred were collected, the data of cases were actively searched, the characteristics of the outbreak were analyzed by descriptive epidemiological methods, and case-control analysis was conducted to identify the transmission route and risk factors.
    Results A total of 21 cases of acute gastroenteritis were reported, the attack rate was 5.77% (21/364). The main clinical manifestations were diarrhea (66.67%), vomiting (47.62%) and abdominal pain (19.05%). A total of 104 samples were collected for nucleic acid detections of norovirus, zarovirus, rotavirus, intestinal adenovirus and astrovirus, and 29 were positive for norovirus GⅡ nucleic acid, the positive rate was 27.88% (29/104). The distribution of cases showed spatial clustering, and there was significant difference in attack rate among workers on different building floors (χ2=33.786, P<0.05). There was significant difference in attack rate between company staff and canteen staff (χ2=29.217, P<0.05). Having lunch at staff canteen on April 25 was a risk factor for the infection (odds ratio=4.50, 95% confidence interval: 1.01−20.11).
    Conclusion The outbreak was caused by GⅡ norovirus. It might be possible that a canteen staff still went to work after the infection, then resulting in secondary infections in canteen staff and company staff. It is suggested that the collective unit should take appropriate measures to strengthen staff health monitoring and conduct timely disinfection.

     

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