一起发生在某高校的诺如病毒感染暴发疫情调查分析  

Investigation and analysis on the outbreak of Norovirus infection in a university

作　　者：王大虎[1] 李美霞[1] 汪慧[1] 鲁影[1] 陈纯[1] 潘心红[1] 李晓宁[1] WANG Dahu;LI Meixia;WANG Hui;LU Ying;CHEN Chun;PAN Xinhong;LI Xiaoning(Guangzhou Center for Disease Control and Prevention,Guangdong510440,China)

机构地区：[1]广州市疾病预防控制中心,广东510440

出　　处：《医学动物防制》2020年第12期1202-1206,共5页Journal of Medical Pest Control

基　　金：广州市科技计划项目(201707010451)。

摘　　要：目的调查广州市某高校一起诺如病毒暴发疫情的原因,采取有针对性的防控措施控制疫情。方法建立病例定义,主动搜索病例资料进行调查,采用描述性流行病学方法分析疫情特征;应用病例对照研究分析暴发疫情的危险因素;采集病例、厨工、留样熟食、桶装水等标本开展病原学检测进行溯源。结果共发病182例,罹患率为0.59%(182/30711)。病例临床症状主要表现为腹泻、呕吐,其中有腹泻症状者(≥3次/日)141例,占77.47%,有呕吐症状者(≥2次/日)15例,占8.24%;腹泻伴呕吐者46例,占25.27%。共检出诺如病毒GII阳性标本27份,分别为现症病例肛拭子15份及A饭堂厨工肛拭子12份。首例病例发病时间为2018年9月17日,20日为发病高峰,末例病例为9月29日。通过"问卷星"设计调查问卷,学生通过手机APP自填问卷。共收回电子问卷6429份,数据清洗后,其中233人作为病例组,挑选健康学生共4288人纳入对照组进行病例对照分析。从9月18~20日,早、中、晚和夜餐在A餐厅就餐均为诺如病毒感染的危险因素。在A餐厅就餐次数与发病存在剂量-反应关系,且关系差异有统计学意义。结论本起疫情判定为由诺如病毒Ⅱ型引起的感染性腹泻暴发疫情,早期食源性传播可能性较大,A餐厅厨工污染是本次疫情的主要危险因素,中后期存在接触传播。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 the outbreak of Norovirus in a university in Guangzhou,and to take targeted prevention and control measures to control the epidemic.Methods Case definition was established to actively search for patients for investigation.The descriptive epidemiological method was used to analyze the characteristics of the epidemic,and case-control study was applied to analyze the risk factors of this outbreak.Samples,such as patients,canteen work,cooked food,barrelled water and so on were collected in order to carry out pathogen detection and trace the source.Results A total of 182 cases were reported in this epidemic,with an attack rate of 0.59%(182/30711).The main clinical symptoms of the cases were diarrhea and vomiting,including 141 cases of diarrhea(≥3 times/day),accounting for 77.47%,15 cases of vomiting symptoms(≥2 times/day),accounting for 8.24%,and 46 cases of diarrhea and vomiting,accounting for 25.27%.A total of 27 positive samples of Norovirus GII were detected,including 15 anal swabs of current cases and 12 anal swabs of A canteen work.The incidence of the first case was on September 17,2018,and September 20 was the peak time.The last case was found on September 29.Through the"Questionnaire Star"design questionnaire,Students filled in the questionnaire designed by"Questionnaire Star"through the mobile APP.A total of 6429 electronic questionnaires were collected.After the data was collated,233 patients were selected as case group and 4288 healthy students were selected as control group in order to conduct case-control analysis.From September 18 to September 20,eating breakfast,lunch,dinner and mid-night snack in A canteen was risk factor for Norovirus infection.There was a dose-response relationship between the time of eating in A canteen and incidence,and the difference was statistically significant.Conclusion The epidemic was determined to be an outbreak of infectious diarrhea caused by Norovirus type II.The possibility of early food-borne transmission was high.The A cante

关 键 词：诺如病毒 腹泻 学生 暴发疫情 调查 

分 类 号：R512.5[医药卫生—内科学]