德阳市某学校一起诺如病毒感染暴发疫情的流行病学调查  

Investigation of An Outbreak of Norovirus Infection in A School in Sichuan Province

作　　者：李杰 刘润友[3] 周兴余[3] 吕强[3] 王海蓉[2] 周立晶 卿俊峰[5] LI Jie;LIU Runyou;ZHOU Xingyu;LV Qiang;WANG Hairong;ZHOU Lijing;QING Junfeng(Sichuan Field Epidemiology Training Program,Chengdu 610041,Sichuan Province,China;Meishan Center for Disease Control and Prevention,Meishan 620010,Sichuan Province,China;Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China;Deyang Center for Disease Control and Prevention,Deyang 618000,Sichuan Province,China;Jingyang District Center for Disease Control and Prevention,Deyang 618000,Sichuan Province,China)

机构地区：[1]四川省现场流行病学培训项目 [2]眉山市疾病预防控制中心,四川眉山620010 [3]四川省疾病预防控制中心,成都610041 [4]德阳市疾病预防控制中心,四川德阳618000 [5]德阳市旌阳区疾病预防控制中心,四川德阳618000

出　　处：《预防医学情报杂志》2019年第9期1048-1052,共5页Journal of Preventive Medicine Information

摘　　要：目的对德阳市某学校发生的1起急性胃肠炎暴发疫情进行流行病学调查和分析,为预防和控制此类暴发疫情提供科学依据。方法 2018-05-19接德阳市报告某学校集中发生胃肠道症状事件,通过制定病例定义、开展病例搜索、调查病例发生情况和可疑传播途径、采集生物和环境标本用RT-PCR方法进行肠道病毒核酸检测等方法进行流行病学调查和分析。结果共搜索到106例病例,均为该校学生,总罹患率为3.70%(106/2 868);南校区罹患率为0.31%(3/953),北校区罹患率为5.38%(103/1 915),南北校区学生罹患率具有统计学差异(χ2=45.84,P<0.05);流行曲线和回顾性队列研究提示17日早餐为危险因素;采集大便、呕吐物、留样食品、外环境样本78份,采用荧光定量RT-PCR法进行实验室检测,检出12份诺如病毒GII型阳性。结论本次疫情为诺如病毒GII型感染的暴发疫情,17日早餐为可疑暴发因素,食堂从业人员诺如病毒隐性感染可能是导致此次疫情的原因。Objective To conduct an epidemiological investigation and analysis of an outbreak of acute gastroenteritis in a school in Sichuan Province, so as to provide a scientific basis for prevention and control of such outbreaks. Methods An outbreak of norovirus infection in one school in Deyang were reported in May 19 th,2018. Through case definitions and case search,the occurrence of cases and suspected routes of transmission were investigated. Biological and environmental samples were collected for RT-PCR to detect the enterovirus nucleic acid, then epidemiological investigation and analysis were conducted. Results A total of 106 cases were detected,all of them were students. The total attack rate was 3.70%(106/2 868). The attack rate in south court of the school was 0.31%(3/953),the attack rate in north court of the school was 5.38%(103/1 915). There was a statistically significant difference in the attack rate of students between the north and south court(χ2=45.84, P<0.05). The prevalence curve and retrospective cohort study suggested that breakfast was a risk factor on the May 17 th. By collecting 78 samples of stool,vomit,sample food and external environment and fluorescence quantitative RT-PCR detection,12 positive norovirus GII samples were found. Conclusion This outbreak was an outbreak of norovirus GII infection. The breakfast on the May 17 th was a suspicious outbreak factor. The hidden infection of Norovirus in the canteen practitioners may be the cause of this outbreak.

关 键 词：诺如病毒 流行病学 暴发 

分 类 号：R725.1[医药卫生—儿科]