一起学校诺如病毒Ⅱ型急性胃肠炎暴发疫情调查  

Survey on an outbreak of acute gastroenteritis caused by norovirus type Ⅱ in a school

作　　者：徐建荣[1] 郑广勇[1] 高丽[1] 陈磊[1] XU Jian-rong;ZHENG Guang-yong;GAO Li;CHEN Lei(Center for Disease Control and Prevention of Xiangshan County, Ningbo, Zhejiang 315700, China)

机构地区：[1]象山县疾病预防控制中心,浙江宁波315700

出　　处：《中国公共卫生管理》2018年第1期48-51,共4页Chinese Journal of Public Health Management

摘　　要：目的调查一起学校诺如病毒暴发疫情的原因,提出有针对性的防控措施。方法建立病例定义,主动搜索患者进行调查,采用描述性流行病学方法分析疫情的特征;应用病例对照研究、队列研究分析本次暴发疫情的危险因子;采集病例、食堂员工、留样熟食、桶装水等标本开展病原学检测。结果本次疫情共发病92例,罹患率为4.50%(92/2 046)。患者临床表现主要以呕吐(98.91%)、恶心(67.39%)、腹痛(55.43%)、头晕(47.83%)、发热(22.83%)、腹泻(3.26%)为主,6份患者标本病毒核酸结果为诺如病毒II型阳性。出现于2015年1月19日,发病高峰为1月20日,末例病例出现于1月27日。采用1∶1配比病例对照方法对饮食、饮水、接触病例等33个危险因素进行分析,病例组与对照组差异无统计学意义;按学生餐具消毒方式不同进行分组,使用蒸汽消毒柜消毒餐具的学生与使用电子消毒柜的学生相对危险度为21.44,前者发病率明显高于后者(χ2=78.08,P<0.01),提示消毒时蒸汽锅炉在运行过程中压力不够,餐具消毒效果受到影响。结论本次暴发疫情是由食堂餐具受到污染且消毒不彻底引起的,采取改进餐具消毒方法,在全校范围内彻底开展环境整治消毒工作,落实隔离制度,疫情很快得到控制。Objective To investigate the causes of an outbreak of norovirus in a school and put forward prevention and control measures. Methods According to the case definition,the patients were searched actively for the investigation. Epidemiological descriptive method was used to analyze the epidemic; Control study and cohort study of risk factors was adopted; Acquisition cases,canteen workers,stay kind of cooked food,bottled water and other samples were collected for pathogen detection. Results The incidence of the cases was 4. 50%（ 92/2046）. The main clinical manifestations of them were vomiting（ 98. 91%）,nausea（ 67. 39%）,abdominal pain（ 55. 43%）,dizziness（ 47. 83%）,fever（ 22. 83%）,diarrhea（ 3. 26%）,and 6 cases of virus nucleic acid results were norovirus II positive. The first case appeared in January 19 th,2015,with fever,sore throat,dizziness and discomfort,the peak was at the end of January 20 th,and the last case appeared in January 27 th. The1： 1 matched case-control study showed that there were no significant differences in the 33 risk factors of diet,drinking water and contact cases between the case group and the control group. According to way of tableware disinfection they used,they divided into two groups. The incidence of the group using steam sterilization cabinet higher than that using electronic disinfection cabinet（ χ2= 78. 08,P 0. 01） with incidence rate ratio of 21. 44. Hygienic investigation showed that the pressure of the steam boiler was not higher enough during the disinfection process using steam disinfection cabinet. Conclusion The outbreak is caused by contamination of the tableware and incomplete disinfection. A tableware disinfection method is adopted to carry out environmental disinfection and disinfection in the whole school,and the quarantine system is implemented. The epidemic situation is quickly controlled.

关 键 词：诺如病毒 腹泻 学生 暴发 调查 

分 类 号：G478.5[文化科学—教育学]