一起诺如病毒GⅡ型感染性胃肠炎聚集性疫情调查  

Epidemiological investigation on an aggregation epidemic of gastroenteritis caused by norovirus GⅡ

作　　者：周丽鸿[1] 张钧[1] 张宏[1] 陆沄鹏 夏瑜[1] 陈立凌[1] 

机构地区：[1]苏州市疾病预防控制中心,江苏苏州215004 [2]苏州市姑苏区疾病预防控制中心,江苏苏州215000

出　　处：《职业与健康》2016年第15期2135-2137,共3页Occupation and Health

基　　金：苏州市医学重点学科项目(Szxk201516)

摘　　要：目的调查苏州市某区幼儿园出现多名急性胃肠炎病例的感染来源、传播途径。方法疑似病例定义:2015年9月20—25日,该班级学生和教职员工中出现腹泻(≥3次/d)或呕吐者。确诊病例为可疑病例中用反转录-聚合酶链反应(RT-PCR)方法检出诺如病毒阳性者。现场流行病学调查,描述三间分布。结果在该班级幼儿罹患率38.24%(13/34)。主要症状是呕吐和发热,聚集性疫情持续时间M=2 d。8份肛拭标本中6份是诺如病毒(NoV)阳性,均为GⅡ型。幼儿的罹患率性别间、在因病缺课、座位、床位分布上差异无统计学意义(P>0.05)。教职员工3人中保育阿姨1人检出NoVGⅡ型。可疑的传染来源为隐性感染者保育阿姨,暴露形式为短期共同来源。结论该幼儿园的急性胃肠炎病例是由GⅡ型NoV引起的,接触传播是主要感染途径。应加强托幼机构的人员监测与防护,保持良好的手卫生是预防NoV感染和控制传播最重要最有效的措施。[Objective] To investigate the source of infection and the route of transmission in acute gastroenteritis cases in a kindergarten of Suzhou City.[Methods]A suspected case was defined as who have had diarrhea（≥3 times/day）or vomiting among teachers or students of the class during September 20-25 in 2015.A confirmed case referred to the suspected case was positive for norovirus in stool specimens by using RT-PCR.A cross-sectional field epidemiological survey was used to describe the spatial,temporal and population distribution.[Results]The attack rate of the children in the class was 38.24%（13/34）.The most frequently observed clinical symptoms were vomiting and fever,and the duration of aggregation epidemic was M=2 d.6 of 8anal swab specimens were positive for norovirus（NoV）,and all were GⅡ type.There were no statistically significant differences in the attack rate of the children among different groups in gender,illness-inducedabsence,seat distribution and bed distribution（P 〉0.05）.Among three teachers,a nursery governess was detected for NoV G Ⅱ.The suspected source of infection was the nursery governess（hidden infection）,and the epidemic was caused by short-term common exposures.[Conclusion]The acute gastroenteritis cases in the kindergarten are caused by NoV GⅡ,and the main route of transmission is contact.It is necessary to strengthen the monitoring and protection in the kindergartens.The good hand hygiene is the most important and effective measure to prevent the spread and infection of NoV.

关 键 词：诺如病毒 聚集性疫情 现场流行病学 

分 类 号：R181.8[医药卫生—流行病学]