摘要
目的分析诺如病毒感染性腹泻聚集性疫情的流行病学及病原学特征,为疫情防控提供科学依据。方法收集2016-2018年深圳市龙华区诺如病毒聚集性疫情调查数据进行描述性流行病学分析,通过实时荧光定量PCR法、Region B和Region C片段序列测定进行亚型鉴定。结果纳入聚集性疫情判定标准的疫情共34起,发病总人数448人,平均罹患率为18.26%(448/2 454),疫情持续时间中位数3 d。疫情主要集中在冬春季节,2016年12月至2017年4月出现1个流行高峰。91.18%(31/34)的疫情发生在学校及托幼机构,年龄以3~6岁的托幼儿童为主(78.79%,353/448)。临床表现散居与托幼儿童人群及中小学组以恶心、呕吐(95.77%,408/426)症状为主,成年人群以腹泻(95.45%,21/22)症状为主,呕吐及腹泻症状在3个年龄组间差异均有统计学意义(χ^2值分别为98.89,99.61,P值均<0.01)。29起疫情传播途径判断为人传人,其中21起疫情病例在校园呕吐物未规范处理。生物样本检出率为49.15%(203/413),均为诺如病毒GⅡ型。其中2016年12月至2017年4月期间,以GⅡ.P16-GⅡ.2基因型为主(49份)。结论诺如病毒极易在托幼机构及学校引起大规模的暴发疫情,早期规范隔离患者及正确处理呕吐物及腹泻物为防控措施的关键环节。
Objective To analyze the epidemiological and etiological characteristics of aggregation epidemics of infectious diarrhea induced by norovirus,and to provide the scientific basis for the prevention and control. Methods A descriptive epidemiological analysis of aggregation epidemics events occurred during 2016-2018 in Longhua District of Shenzhen was carried out,with subtypes identified by real-time fluorescence quantitative PCR,Region B and Region C fragment sequence determination. Results There were 34 aggregation epidemic events,including 448 cases,the mean attack rate was 18.26%( 448/2 454). The median duration of aggregation epidemic was 3 days. The peak season appeared in autumn and winter,and the peak of epidemic emerged from December 2016 to April 2017. About 91.18%( 31/34) of the epidemics occurred in schools and child care centers,and among children aged 3-6 years( 78.79%,353/448). The clinical symptoms were mainly nausea and vomiting( 95.77%,408/426) in children and adolescents but diarrhea in adult group( 95.45%,21/22). The differences between vomiting and diarrhea were both statistically significant in the two age groups( χ^2= 98.89,99.61,P<0.01). 29 cases were transmitted through interpersonal network,of which 21 cases were found to have unregulated treatment of vomit on campus. The detection rate of biological samples was49.15%( 203/413),all of which were GⅡ norovirus. The genotype was mainly GⅡ.P16-GⅡ.2( n = 49) from November 2016 to April 2017. Conclusion Norovirus can cause large-scale outbreaks in child care centers and schools easily. Early standardized patient isolation and proper management of vomit and diarrhea are the key steps in prevention and control measures.
作者
陈其娴
许少坚
周世权
刘丽珍
彭伟军
罗经伟
CHEN Qixian;XU Shaojian;ZHOU Shiquan;LIU Lizhen;PENG Weijun;LUO Jingwei(Epidemic and Infectious Disease Control Depertment,Center for Disease Control and Prevention of Longhua District,Shenzhen(518109),Guangdong Province,China)
出处
《中国学校卫生》
CAS
北大核心
2020年第3期398-400,共3页
Chinese Journal of School Health
基金
深圳市龙华区2018年科技创新专项资金资助项目(2017066)。
关键词
腹泻
肠道病毒感染
疾病暴发流行
流行病学研究
学生
Diarrhea
Enterovirus/infections
Disease outbreaks
Epidemiologic studies
Students
作者简介
陈其娴(1985-),女,广东汕头人,大学本科,主管医师,主要从事传染病控制工作。
