一起高校二次供水被GⅡ.17型诺如病毒污染所致的急性胃肠炎暴发调查  

An outbreak of acute GⅡ.17 norovirus gastroenteritis associated with contamination of secondary water supply in a university

作　　者：吴杨[1] 刘力[1] 刘漫[1] 官旭华[1] 邢学森[1] 李旦[2] WU Yang , LIU Li, LIU Man, GUAN Xu-hua, XING Xue-sen, LI Dan(Research Institute for Infectious Diseases, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei 430079, China)

机构地区：[1]湖北省疾病预防控制中心传染病所,湖北武汉430079 [2]荆门市疾病预防控制中心

出　　处：《实用预防医学》2018年第11期1334-1337,共4页Practical Preventive Medicine

基　　金：湖北省卫生和计划生育委员会疾控及医药院校科研专项(WJ2016J-008)

摘　　要：目的查明2017年湖北省某高校急性胃肠炎暴发疫情的致病因子、传播途径、危险因素。方法根据病例定义开展搜索、个案调查,对危险因素进行回顾性队列研究和病例对照研究,对供水系统进行现场调查,采集标本开展诺如病毒核酸检测。结果 2017年5月1-12日,共搜索到病例80例,91. 3%(73/80)病例来自该校S学院,S学院罹患率为4. 5%(73/1 612)。5月1-8日,S学院学生和教职工中到过实验楼者、未到实验楼者发病率分别为5. 4%(73/1 354)和0%(0/258),差异有统计学意义(χ2=14. 570,P=0. 000);曾在实验楼洗水果吃的发病风险是未暴露组的7. 1倍(95%CI:2. 74～18. 42)。10份病例标本、1份二次供水顶层水箱水样、3份实验室的末梢水样、2份实验室水龙头物表涂抹样本均检出诺如病毒GⅡ. 17型核酸阳性。结论本次急性胃肠炎暴发因二次供水被诺如病毒GⅡ. 17污染所导致,建议加强学校二次供水卫生学监管力度。Objective To ascertain the pathogenic factors of infection,route of transmission and risk factors related to a cluster of acute gastroenteritis cases in a university in Hubei Province in 2017. Methods The cases were searched and surveyed according to case definitions. A retrospective cohort study and a case-control study were performed to explore the risk factors. A field investigation was conducted to survey the water supply system. Specimens were collected for the detection of norovirus nucleic acid.Results A total of 80 cases were searched from May 1 to 12,2017. 91.3%（ 73/80） cases came from S school of the university,with the attack rate being 4.5%（ 73/1,612）. From May 1 to 8,the incidence rates of students and staff with and without a visit to experiment building in S school were 5. 4%（ 73/1,354） and 0%（ 0/258） respectively,with a statistically significant difference（ χ2= 14.570,P = 0.000）. The incidence risk of staff and students who had eaten fruit washed by the water of experiment building was 7. 1（ 95%CI： 2.74-18.42） times that of the non-exposure group. 10 specimens from the cases,1 sample form secondary water supply tank of the top floor,3 samples from laboratory peripheral water and 2 samples from laboratory taps were GⅡ.17 norovirus positive. Conclusions This acute gastroenteritis outbreak is caused by secondary water supply polluted by GⅡ.17 norovirus. It is necessary to intensify the hygiene supervision on secondary water supply in the university.

关 键 词：诺如病毒 急性胃肠炎 暴发 二次供水 

分 类 号：R512.5[医药卫生—内科学]