某集镇一起自来水污染引起的诺如病毒胃肠炎暴发调查  

A gastroenteritis outbreak caused by tap water polluted by norovirus in a town of Zhejiang

作　　者：孙昼[1] 方利洪[2] 徐哲[2] 考庆君[1] 谢立[1] 

机构地区：[1]浙江省杭州市疾病预防控制中心,浙江杭州310021 [2]浙江省建德市疾病预防控制中心,浙江建德311600

出　　处：《中国农村卫生事业管理》2016年第4期446-448,共3页Chinese Rural Health Service Administration

摘　　要：目的:查明一起诺如病毒感染暴发疫情流行特征及病因,以制定有效防控措施,迅速控制疫情。方法:制订病例定义,采用统一印制调查表对病例进行个案调查,采用病例对照调查对63例病例及73例对照进行问卷调查,计算OR值及95%CI;采集病例粪便(肛拭子)、未梢水及溪水样本,用RT-PCR方法进行诺如病毒核酸检测。结果:共报告病例230例,罹患率达0.51%(230/45075),疫情持续15天,病例分布与镇自来水厂管网一致。病例对照调查结果显示,"使用集镇自来水"1项危险因素有统计学意义。9份现症病例肛拭子(9/12)及1份溪水标本经检测诺如病毒Ⅱ型核酸呈阳性。结论:居民使用受致病菌污染的自来水是引起疫情的主要因素,需加强农村及集体单位饮用水管理,杜绝此类疫情发生。Objective To describe the characteristics and etiology of a gastroenteritis outbreak in a rural town for the effective prevention and control of the disease. Methods Case definition was established and a unified questionnaire was used in case survey. A questionnaire investigation was made among 63 cases and a control group of 73 normal subjects involved using the case--control study. The odds ratio（OR） and 95~CI were calculated. Feces （anal swabs） from pa- tients,tap water samples and stream water samples were collected. Norovirus nucleic acids were tested by Real--time PCR. Results Totally 230 cases were reported and the attack rate was 0.51% （230/45075）. The outbreak lasted 15 days and the distribution of cases was in keeping with the change of water supply pipeline. The result of case--control study showed that ＂using tap water＂ had statistically significant difference. 9 of 12 feces （anal swabs） and a sample of stream water were positive for norovirus ]] nucleic acid by RT--PCR test. Conclusions The use of tap water polluted by noro- virus was the main factor contributing to the outbreak in town. The management of drinking water in rural areas and collective units should be strengthened for the avoidance of such occurrences.

关 键 词：诺如病毒 暴发疫情 水污染 调查 

分 类 号：R512.5[医药卫生—内科学]