一起高校诺如病毒感染性腹泻暴发的调查  

Investigation on an outbreak of acute norovirus gastroenteritis in a university

作　　者：李世娥[1] 周浩[1] 刘金茹[1] 王勇[1] 金德利[2] 王建[1] 杨超[1] 肖凤娟[1] 冯茜[1] 郭淑珍[1] LI Shi-e;ZHOU Hao;LIU Jin-ru;WANG Yong;JIN De-li;WANG Jian;YANG Chao;XIAO Feng-juan;FENG Qian;GUO Shu-zhen(Harbin Municipal Center for Disease Control and Prevention,Harbin,Heilongjiang 150056,China;Center for Disease Control and Prevention of Nangang District in Harbin)

机构地区：[1]哈尔滨市疾病预防控制中心,黑龙江哈尔滨150056 [2]哈尔滨市南岗区疾病预防控制中心

出　　处：《中国公共卫生管理》2018年第4期567-569,572,共4页Chinese Journal of Public Health Management

摘　　要：目的调查某高校胃肠炎病例的感染来源、传播途径和危险因素。方法对病例进行回顾性调查,描述疫情三间分布特征,调查可疑因素,开展病例对照研究验证暴发的可能原因。运用RT-PCR法进行诺如病毒、腺病毒及轮状病毒核酸检测和致病菌检测。结果本疫情共持续9天,病例共77例,罹患率0.93%。病例对照研究结果显示在饮食中心二层、三层就餐情况差异有统计学(χ~2=5.28,P<0.05)。13份病例肛拭子样本诺如病毒核酸检测为阳性10份,其中GI型3份,GII型7份,未检出轮状病毒和肠道腺病毒,未检出相关致病菌。20份该校食堂厨工(无症状)肛拭子诺如病毒核酸检测,结果阳性3份,GⅡ型;首发病例3日前就餐的餐厅4名厨师肛拭子诺如病毒核酸检测结果为阴性。结论本次事件是一起诺如病毒感染引起的暴发疫情,食源性传播后出现人-人传播,可能是由食品从业人员直接或间接污染食物所致。Objective To identify the infection source,transmission route and risk factors of an acute gastroenteritis. Methods The cases were surveyed by retrospective epidemiological investigation. The suspicious factors were surveyed and the distribution characteristic were described. The hypothesis for this outbreak was test by a case-control study. The norovirus,adenovirus and rotavirus in the anus swab samples of food worker and patients were detected by RT-PCR,and the pathogenic bacteria were also detected. Results The outbreak lasted for 9 days,and 77 cases were identified,according for 0. 93%.There were statistically significant（ χ^2= 5. 28,P〈0. 05） between the second floor and the third floor in the school canteen.Thirteen cases of anal swabs samples were 10 positive for norovirus nucleic acid,3 for GI and 7 for GII. There was no adenovirus,no rotavirus,and no pathogenic bacteria. Twenty cases of chefs（ asymptomatic） anal swabs were detected by NRV nucleic acid,the positive results were 3 with G II,and 4 chef＇s anal swabs were tested negative for the first 3 days before the first case. Conclusion The norovirus outbreak may be caused by the contamination food of norovirus in school canteen by food workers,and the route of transmission was people-people spread after food-borne spread.

关 键 词：诺如病毒 暴发 高校 

分 类 号：R183.4[医药卫生—流行病学] R181.81[医药卫生—公共卫生与预防医学]