2018年成都市学校和托幼机构诺如病毒感染性腹泻聚集性疫情及影响因素分析  

Norovirus Epidemics Cluster Infectious Diarrhea in Kindergartens and Schools and Its Associations Factors in Chengdu in 2018

作　　者：戴映雪[1,2] 速丽媛[1] 刘云升 陈恒[1] 岳勇[1] 韩德琳[1] DAI Yingxue;SU Liyuan;LIU Yunsheng;CHEN Heng;YUE Yong;HAN Delin(Chengdu Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China;West China School of Public Health,Chengdu 610041,Sichuan Province,China)

机构地区：[1]成都市疾病预防控制中心,成都610041 [2]四川大学华西公共卫生学院/四川大学华西第四医院,成都610041

出　　处：《预防医学情报杂志》2020年第3期269-275,共7页Journal of Preventive Medicine Information

基　　金：四川省卫生计生委重点项目(项目编号:17ZD046)。

摘　　要：目的分析2018年成都市学校和托幼机构诺如病毒感染聚集性疫情分布及其影响因素,为学校防控提供科学依据。方法共纳入成都市128起诺如病毒感染聚集性疫情,分别采用卡方检验和方差分析比较分类和连续性资料,采用二元非条件Logistic回归分析疫情规模和持续时间的影响因素。结果 128起疫情主要发生在10-12月(55.47%)、主城区(60.94%)和托幼机构(50.78%)。疫情病例中位数9例,持续时间中位数30 h。首发病例在家发病但第2天仍入校的疫情中,大规模疫情(>9例)占58.33%,高于首发在家且第2天未入校(21.21%)或首发在校的疫情(52.54%)。疫情中腹泻发生比例的中位数约17%,比例大于17%的疫情,长持续时间疫情(>30 h)占比更大,为58.33%。影响因素分析显示,相较于首发在家的疫情,首发在家发病后第2天仍入校的疫情规模更大(OR=4.56,95%CI:1.35~15.46),首发在校的疫情规模也更大(OR=3.52,95%CI:1.07~11.65)。相较于腹泻发生比例<17%的疫情,>17%的疫情持续时间更长(OR=5.16,95%CI:1.96~13.61)。结论为控制诺如疫情规模和持续时间,学校、托幼机构严格实施晨检和因病缺勤追踪,促进家长主动及时报告病情,同时加强重点场所的清洁消毒措施。Objective To explore the distribution and association factors of Norovirus cluster infections in Chengdu 2018,and to provide scientific reference for Norovirus control. Methods A total of 128 epidemics were included. Chi-square and t-test were used to compare categorical and continuous data respectively. Binary unconditional Logistic regression was applied to test the associations.Results Most epidemics happened from October to December(55.47%), in the center area(60.94%) and kindergartens(50.78%). The median of the number of cases was 9 and the median of lasting period was 30 hours for the epidemics. The proportion of large-scale epidemic(>9 cases) was 58.33% when the first case had symptoms at home but went to school on the second day, bigger than that when the first case had symptoms at home(21.21%) or at school(52.54%). When the proportion of diarrhea symptoms was beyond 17%,more epidemics(58.33%)last more than 30 hours. Compared to the epidemics when the first case had symptoms at home,the epidemics when the first case had symptoms at home but went to school on the second day were more likely to be large-scale(OR=4.56, 95% CI: 1.35-15.46), and the epidemics when the first case had symptoms at school were also more likely to be large-scale(OR=3.52, 95% CI:1.07-11.65). Compared to the epidemics that less than 17% cases had diarrhea, the epidemics that more than 17% cases had diarrhea were more likely to last a longer time(OR=5.16,95%CI:1.96-13.61). Conclusion Schools and kindergartens should strictly conduct morningcheck and absence-inquiry among students,and promote parents truly report the illness,as well as enhancing cleaning and sterilization.

关 键 词：诺如病毒 聚集性疫情 学校 托幼机构 

分 类 号：R512.5[医药卫生—内科学]