摘要
目的 调查绵阳市某中学一起诺如病毒暴发感染的来源、传播途径及相关危险因素,为类似事件的防控提供参考依据。方法 2021-03-10接大疫情突发事件管理信息系统报告绵阳市某中学发生1起诺如病毒暴发疫情,核实暴发后,通过制定病例定义,开展病例搜索,采集病例和环境样品标本进行检验,1∶1病例对照分析相关危险因素进行流行病学调查和分析,采用SPSS 21.0软件进行χ^(2)检验。结果 共搜索到病例180例,学生144例,教职工32例,食堂工作人员4例,总罹患率为17.27%。流行病学曲线显示本次疫情为人传人传播模式,首例病例为一名老师,且教职工的发病高峰期早于学生。病例对照研究显示接触腹泻/呕吐病人(OR=6.35,95%CI:2.467~16.282)、清理/处置过呕吐物或粪便(OR=8.691,95%CI:1.064~71.024)为危险因素。采集食堂留样食品和食堂物体表面样本 14 份,均为阴性;采集肛拭子 83 份、大便样本59份,诺如病毒阳性66份;对59份大便样本进行基因分型,GⅠ型20份,GⅡ型17份,其中5份样本同时测出GⅠ型、GⅡ型阳性,其余样本GⅠ型、GⅡ型阴性。自备井水细菌总数和大肠菌群超标。结论 本次疫情为诺如病毒GⅠ型、GⅡ型混合引起的人传人暴发流行。
Objictive To investigate the source,transmission route and related risk factors of an outbreak of norovirus infection in a middle school in Mianyang city,so that to provide a reference for the prevention and control of similar incidents.Methods 2021- 03- 10,the emergency management information system of the pandemic reported a norovirus outbreak in a middle schoo in Mianyang city.After verifying the outbreak,formulate case definitions,case searches,collec case and environmental samples for testing was conducted,and relevant risk factors through 1∶1case control was analyzed.Chi-square test was used by SPSS 21.0 software.Results A total of 180cases were searched,144 were students,32 were faculty and staff,and 4 were canteen staffs.The total attack rate was 17.27%.The epidemiological curve showed that this epidemic was a human-tohuman transmission mode,the first case was a teacher,and the peak incidence of faculty and staff was earlier than that of students.A case-control study showed that exposure to patients with diarrhea/vomiting (OR=6.35,95% CI:2.467~16.282),cleaning/handling of vomit or feces (OR=8.691,95%CI:1.064~71.024) were risk factors.And 14 samples of food kept in the canteen and surface samples of the canteen were collected,all of which were negative;83 anal swabs and 59 stool samples were collected,66 of which were positive for norovirus;Genotyping was performed on 59stool samples,20 of which were G Ⅰ and 17 were G Ⅱ.Among them,5 samples were tested positive for G Ⅰ and G Ⅱ at the same time.The remaining samples were negative for type G Ⅰand G Ⅱ.The total number of bacteria and coliforms in self- provided well water exceeds the standard.Conclusions This epidemic is an outbreak of human- to- human transmission caused by a mixture of Norovirus Types GⅠ and GⅡ.
作者
王保东
刘伦光
吴朝学
朱元芳
WANG Bao-dong;LIU Lun-guang;WU Chao-xue;ZHU Yuan-fang(Mianyang Center for Disease Control and Prevention,Mianyang 621000,Sichuan Province,China;Sichuan Provincial Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China;Gulin County Center for Disease Control and Prevention,Gulin 646500,Sichuan Province,China)
出处
《预防医学情报杂志》
CAS
2022年第6期814-818,共5页
Journal of Preventive Medicine Information
基金
四川省现场流行病学培训项目。
作者简介
王保东(1984-),男,硕士,副主任医师,传染病控制,E-mail:584290284@qq.com;通信作者:刘伦光,E-mail:270105431@qq.com。
