上海市2010-2014年确认和疑似诺如病毒感染聚集性疫情流行病学分析  

Epidemiology of confirmed and suspected norovirus outbreaks in Shanghai, 2010-2014

作　　者：黎健[1] 潘浩[1] 肖文佳[1] 胡家瑜[1] 袁政安[1] 

机构地区：[1]上海市疾病预防控制中心急性传染病防治科,200336

出　　处：《中华流行病学杂志》2015年第11期1249-1252,共4页Chinese Journal of Epidemiology

基　　金：上海市公共卫生重点学科建设计划（12GWZX0101）;上海市现场流行病学项目

摘　　要：目的 分析2010-2014年上海市确认或疑似诺如病毒感染聚集性疫情及其流行病学特征.方法 统计分析2010年1月至2014年11月上海市报告的确认或疑似诺如病毒聚集性疫情的调查报告.结果 共报告80起聚集性疫情,报告病例总数为2 399例,总罹患率为4.17％.聚集性疫情持续时间M=4.5 d,疫情达到峰值时间M=2d.秋冬季疫情高发,10月至翌年2月共发生53起,占总例数的66.25％.发生在学校、幼儿园和养老院的疫情共75起（93.75％）.医院住院病例和养老院老年人罹患率高于托幼儿童及学生,差异有统计学意义（x2=683.12,P＜0.01）;集体机构员工罹患率均低于其服务对象的罹患率.临床症状以呕吐为主,共1 900例（79.20％）,腹泻和发热仅分别为694例（28.93％）和364例（15.17％）,差异有统计学意义（x2=2 251.48,P＜0.01）.短期共同来源为主要暴露形式,接触传播是主要感染途径.结论 2010-2014年上海市诺如病毒聚集性疫情主要发生在秋冬季和集体机构,应加强重点地区和人员监测及防护.Objective To understand the epidemiologic characteristics of confirmed and suspected norovirus outbreaks in Shanghai during 2010-2014.Methods The investigation reports of confirmed and suspected norovirus outbreaks in Shanghai from 2010 to 2014 were analyzed.Results A total of 80 norovirus outbreaks, involving 2 399 cases, were reported during this period, and the overall attack rate was 4.17%.The median of the outbreak duration was 4.5 days and the incidence peaked 2 days later averagety for an outbreak.The outbreaks mainly occurred in autumn and winter,53 outbreaks occurred during October-February, accounting for 66.25%.Seventy five outbreaks occurred in schools, child care settings and nursing houses, accounting for 93.75%.The attack rates in hospitalized patients and the elders in nursing houses were higher than those in pre-school and school aged children, the differences were statistically significant （x2=683.12, P〈0.01）.The attack rates in medical staff and nurses in hospitals and nursing houses or staff in pre-schools and schools were lower.Vomiting, the main clinical symptom, occurred in 1 900 cases （79.20%）, diarrhea and fever developed in 694 cases （28.93%） and 364 cases （15.17%） respectively.The differences were statistically significant （x2 =2 251.48, P〈0.01）.The outbreaks were mainly caused by short common exposures and contact with cases.Conclusion The surveillance for norovirus infection should be strengthened in hospitals, schools and others with the crowed during autumn-winter.The protection of risk population should be enhanced.

关 键 词：诺如病毒 聚集性疫情 流行病学 

分 类 号：R181.3[医药卫生—流行病学] R512.5[医药卫生—公共卫生与预防医学]