罗银波, 刘力, 杨栋, 刘漫, 胡傲容, 官旭华, 童叶青, 吴杨. 湖北省随州市某工厂一起诺如病毒感染性腹泻暴发调查[J]. 疾病监测, 2022, 37(8): 1128-1133. DOI: 10.3784/jbjc.202110280565
引用本文: 罗银波, 刘力, 杨栋, 刘漫, 胡傲容, 官旭华, 童叶青, 吴杨. 湖北省随州市某工厂一起诺如病毒感染性腹泻暴发调查[J]. 疾病监测, 2022, 37(8): 1128-1133. DOI: 10.3784/jbjc.202110280565
Luo Yinbo, Liu Li, Yang Dong, Liu Man, Hu Aorong, Guan Xuhua, Tong Yeqing, Wu Yang. Outbreak of infectious diarrhea associated with norovirus in a factory in Suizhou city, Hubei province[J]. Disease Surveillance, 2022, 37(8): 1128-1133. DOI: 10.3784/jbjc.202110280565
Citation: Luo Yinbo, Liu Li, Yang Dong, Liu Man, Hu Aorong, Guan Xuhua, Tong Yeqing, Wu Yang. Outbreak of infectious diarrhea associated with norovirus in a factory in Suizhou city, Hubei province[J]. Disease Surveillance, 2022, 37(8): 1128-1133. DOI: 10.3784/jbjc.202110280565

湖北省随州市某工厂一起诺如病毒感染性腹泻暴发调查

Outbreak of infectious diarrhea associated with norovirus in a factory in Suizhou city, Hubei province

  • 摘要:
      目的  调查2021年9月湖北省随州市某工厂一起急性胃肠炎疫情的感染来源、传播途径和危险因素,提出防控建议。
      方法  制定病例定义搜索病例,描述病例的临床表现及三间分布特征,开展回顾性队列研究验证暴发的危险因素,采集病例肛拭子样本、环境涂抹样及水样进行诺如病毒PCR检测。
      结果  本次疫情涉及A和B两个工厂,共发现68例病例和7例隐性感染者,临床症状以腹泻和呕吐为主;病例发病高峰在8月31日18时至9月1日6时(48例),流行曲线呈点源暴露模式;病例主要分布在A工厂的加二车间、加一车间及B工厂;回顾性队列研究发现,和未在食堂就餐相比,A工厂员工8月30日中午在一食堂(RR=3.366,95%CI:1.321~8.577)和二食堂(RR=10.662,95%CI:4.795~23.706)就餐为发病的风险因素;实验室检测结果显示,44份工人肛拭子样本中有25份为Ⅱ型诺如病毒核酸阳性,16份食堂员工肛拭子样本中有2份为Ⅱ型诺如病毒核酸阳性,10份水样中有4份诺如病毒核酸阳性(3份GⅡ阳性,1份GⅠ和Ⅱ混合阳性),22份外环境样本中有2份Ⅱ型诺如病毒核酸阳性。
      结论  本次疫情为一起诺如病毒GⅡ感染引起的暴发疫情,推测主要因水管破裂导致水源污染,后主要通过污染食物供应,引起此次暴发疫情的可能性较大,传播途径以食源性传播为主,部分病例存在水源性及人与人传播的可能性,经加强病例管理、环境消杀及健康教育等防控措施后疫情得到控制。

     

    Abstract:
      Objective  Investigate the source of infection, transmission routes and risk factors of an outbreak of acute gastroenteritis in a factory in Suizhou City, Hubei Province in September 2021, and put forward prevention and control recommendations.
      Methods  In this study, case definitions were developed to search for cases, and then the clinical manifestations and three distribution characteristics of the cases were described. A retrospective cohort study was carried out to verify the risk factors for the outbreak. Samples from cases, water and environment were collected for the PCR detection of norovirus.
      Results  The epidemic involved Factory A and B. A total of 68 cases and 7 cases of latent infections were found. The main clinical symptoms are diarrhea and vomiting. The peak incidence of cases was from 18:00 on August 31 to 06:00 on September 1 (48 cases). The epidemic curve showed a point-source exposure pattern. The cases were mainly distributed in the second and first workshops of Factory A and Factory B. A retrospective cohort study found that compared with not eating in the canteen, having lunch in the first (RR=3.366, 95%CI: 1.321–8.577) and second (RR=10.662, 95%CI: 4.795–23.706) canteen on August 30 was a risk factor for the disease. Laboratory test results showed that 25 norovirus GⅡ positive samples were detected in 44 anal swab samples of workers; 2 norovirus GⅡ positive samples were detected in 16 anal swab samples of canteen employee; 4 norovirus positive samples were detected in 10 water samples (3 norovirus GⅡ positive and 1 norovirus G Ⅰ and Ⅱ mixed positive); 2 norovirus GⅡ positive samples were detected in 22 environmental samples.
      Conclusion  This epidemic is an outbreak caused by norovirus GⅡ infection. It is speculated that the main cause of water source pollution due to the rupture of the water pipe, and then mainly through the contamination of food supply,which is more likely to cause this outbreak. The main way of transmission is food-borne transmission, and some cases have the possibility of water-borne and human-to-human transmission. After a series of prevention and control measures such as strengthening case management, environmental disinfection and health education, the epidemic has been controlled.

     

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