一起疑似食源性诺如病毒暴发的流行病学调查  

An epidemiological investigation on a suspected foodborne outbreak of norovirus

作　　者：蔡文锋[1] 杨翠辉[2] 马晓薇[1] 杨丽莉[2] 范建文[2] 刘于飞[1] 陈建东[1] 

机构地区：[1]广州市疾病预防控制中心,广东广州510440 [2]广州市荔湾区疾病预防控制中心,广东广州510176

出　　处：《热带医学杂志》2014年第2期254-257,共4页Journal of Tropical Medicine

摘　　要：目的调查广州市某小学出现多名急性胃肠炎病例的感染来源、传播途径和危险因素。方法按照病例定义开展病例搜索，采用描述性流行病学和病例对照研究方法进行分析；样本采用RT．PCR方法检测诺如病毒核酸。结果2013年3月28～31日，共发生诺如病毒感染性腹泻27例，罹患率为3．31％（27／816）。3月28日14：00—22：00时为发病高峰，病例有班级聚集性，病例对照结果显示饭前洗手（OR=0．13，95％CI：0．03—0．63）和每天洗手次数≥5次（OR=0．26，95％CI：0．10～0．72）为保护因素。采集患者、厨工肛拭子、剩余食物及环境涂抹样等85份标本，其中5份检出诺如病毒GII-4型。结论这是一起由诺如病毒GII-4型引起的急性胃肠炎暴发，暴发原因是带毒厨工污染部分食物所致，以食源性传播为主。Objecive To identify the source of infection, route of transmission and risk factors of a cluster of acute gastroenteritis cases in a primary school of Guangzhou. Methods Cases were identified according to the case definition. Descriptive epidemiological approaches and case-control study designs were employed for the analysis. The samples were tested for norovirus by RT-PCR. Results A total of 27 cases of norovirus gastroenteritis were identified in March 28 to 31, 2013 and the attack rate was 3.31%（27/816）. The peak in morbidity was seen on March 28 at 14：00 to 22：00. Clustering was found in classes. The case-control study revealed that washing hands before meals （OR=0.13,95%CI： 0.03N0.63） and wash hands more than 5 times a day（OR=0.26,95%CI： 0.10~0.72） were protective factors. A total of 85 samples, including rectal swabs from the patients and Kitchen workers, leftovers and environmental swabs were collected. Five samples were positive for norovirus G II detected by RT-PCR. Conclusion This is the acute gastroenteritis outbreak caused by the norovirus genotype II-4.It was a foodborne outbreak in which food was contaminated by the asymptomatie kitchen workers who carried the virus.

关 键 词：诺如病毒 急性胃肠炎 RT—PCR 

分 类 号：R573.3[医药卫生—消化系统]