白尧, 李焱, 刘继锋, 陈志军. 2019年陕西省西安市一起医院内诺如病毒感染暴发疫情调查[J]. 疾病监测, 2020, 35(8): 773-776. DOI: 10.3784/j.issn.1003-9961.2020.08.021
引用本文: 白尧, 李焱, 刘继锋, 陈志军. 2019年陕西省西安市一起医院内诺如病毒感染暴发疫情调查[J]. 疾病监测, 2020, 35(8): 773-776. DOI: 10.3784/j.issn.1003-9961.2020.08.021
Yao Bai, Yan Li, Jifeng Liu, Zhijun Chen. An outbreak of norovirus infection in a hospital in Xi'an, Shaanxi, 2019[J]. Disease Surveillance, 2020, 35(8): 773-776. DOI: 10.3784/j.issn.1003-9961.2020.08.021
Citation: Yao Bai, Yan Li, Jifeng Liu, Zhijun Chen. An outbreak of norovirus infection in a hospital in Xi'an, Shaanxi, 2019[J]. Disease Surveillance, 2020, 35(8): 773-776. DOI: 10.3784/j.issn.1003-9961.2020.08.021

2019年陕西省西安市一起医院内诺如病毒感染暴发疫情调查

An outbreak of norovirus infection in a hospital in Xi'an, Shaanxi, 2019

  • 摘要:
    目的调查2019年西安市X大学第一附属医院住院患者腹泻暴发疫情的致病因子或危险因素,提出针对性防控措施和建议。
    方法开展病例搜索和现场流行病学、卫生学调查,采集病例及相关人员、医院水及环境表面等标本,并通过反转录–聚合酶链式反应(RT-PCR)进行病原学检测。
    结果调查住院患者、家属陪护、医院职工169人,累计发病22例,总罹患率为13.02%。 病例临床表现以腹泻、腹胀、呕吐等为主。 病区住院患者罹患率明显高于家属陪护(χ2=16.341,P<0.01);与首发病例共用厕所的住院患者及其家属陪护罹患率明显高于不共用厕所者(χ2 =3.907,P< 0.05)。 尚未发现水源性和食源性可疑危险因素。 20份病例标本和1份病房拖把表面涂抹标本检测结果为诺如病毒GⅡ型核酸阳性。
    结论该起急性胃肠炎暴发疫情属于医院感染事件,由诺如病毒GⅡ型引起。 传染源为隐性感染者或病毒携带者, 病毒通过病房污染拖把(共同介质)以人–环境–人的模式造成传播, 采取针对性措施后疫情得以控制。

     

    Abstract:
    ObjectiveTo investigate the risk factors of a diarrhea outbreak in the first affiliated hospital of X University in Xi'an in 2019 and provide evidence for the outbreak prevention and control.
    MethodsCase finding, field epidemiologic and hygienic investigation were conducted, and stool samples or anal swabs, vomitus of patients, and water samples and environmental surface swabs in the hospital were collected. RT-PCR was performed for pathogen identification.
    ResultsA total of 22 cases of diarrhea were reported in 169 inpatients, family members and hospital staff. The attack rate was 13.02%. The main clinical manifestations were diarrhea, abdominal distension and vomiting. The attack rate in inpatients was higher than that in their family member ( χ2 =16.341, P<0.01). The attack rate in inpatients and their family members sharing toilet with the first case was significantly higher than in those who sharing no toilet with the case ( χ2 =3.907, P<0.05). No risk factors from water and food samples were found. Twenty cases’ samples were positive for norovirus GⅡ and one mop surface smear collected in the ward was positive for norovirus GⅡ.
    ConclusionThe outbreak of acute gastroenteritis in the inpatients, which was identified as a nosocomial infection event, was caused by norovirus GⅡ. The infectious source was the inapparent infected person or virus carrier. The spread of the virus was through the human-environment-human mode through the use of some contaminated mops in the ward. So, after targeted measures were taken, the outbreak was controlled effectively.

     

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