常州市某中学1起由GI型诺如病毒感染引起的急性胃肠炎暴发疫情调查  

Investigation on outbreak of acute gastroenteritis caused by GI norovirus in a junior high school of Changzhou City

作　　者：陈权[1,2] 李骏 陈聪 祖荣强[2] CHEN Quan;LI Jun;CHEN Cong;ZU Rong-qiang(Department of Acute Infectious Diseases,Kunshan Center for Disease Control and Prerention,Kunshan Jiangsu,215300,China;Jiangsu Field Epidemiology Training Program,Nanjing Jiangsu,210009,China;Institute for Prevention and Control of Acute Infectious Diseases,Changzhou Center for Disease Control and Prevention,Changzhou Jiangsu,213000,China)

机构地区：[1]昆山市疾病预防控制中心急性传染病防治科,江苏昆山215300 [2]江苏省现场流行病学培训项目,江苏南京210009 [3]常州市疾病预防控制中心急性传染病防制所,江苏常州213000

出　　处：《职业与健康》2021年第2期258-261,265,共5页Occupation and Health

基　　金：昆山市社会发展科技专项(KS1546);江苏省卫生计生委科研课题(Y2018026)。

摘　　要：目的查明1起急性胃肠炎暴发疫情的致病因子、感染来源及其危险因素,控制疫情蔓延。方法2019年5月常州市某中学发生1起急性胃肠炎暴发疫情,按照病例定义开展病例搜索,进行个案调查。收集学校环境卫生情况、饮食和供水等信息。选择全部学生开展回顾性队列研究,运用描述性和分析性流行病学方法对暴发特征和影响因素进行单因素和多因素分析。采集22名病例、10名对照和8名食堂工作人员肛拭子标本检测诺如病毒核酸。结果该起暴发疫情总罹患率为11.5%(84/731);流行曲线提示人传人。多因素分析显示,饮用桶装开水(RR=2.2,95%CI:1.1~4.8)和近距离暴露于呕吐物(RR=3.2,95%CI:1.2~8.4)为发病独立危险因素,餐前洗手使用清洁剂为独立保护因素(RR=0.5,95%CI:0.3~0.9)。10名病例肛拭子GI型诺如病毒核酸检测阳性。结论这是1起由GI型诺如病毒感染引起的人传人急性胃肠炎暴发疫情,开水桶表面污染是快速传播的重要媒介。Objective To identify pathogens,sources of infection and related factors of an acute gastroenteritis outbreak,provide evidence for controlling the spread of the epidemic.Methods In May 2019,an outbreak of acute gastroenteritis occurred in a junior high school of Changzhou City,then case search was conducted according to the case definition,and case investigation was performed.The information about school environmental sanitation,diet and water supply was collected.All students were included to conduct retrospective cohort study.Univariate and multivariate analysis on outbreak characteristics and influencing factors were conducted by descriptive and analytical epidemiological methods.Anal swab samples were collected from 22 cases,10 controls and 8 canteen workers for the detection of novoviral nucleic acid.Results The total attack rate of the outbreak was 11.5%(84/731).The epidemic curve indicated a person-to-person transmission mode.Multivariable analysis showed that drinking bottled boiled water(RR=2.2,95%CI:1.1-4.8)and exposure to vomit(RR=3.2,95%CI:1.2-8.4)were independent risk factors,while washing hands before meals with detergent was independent protective factor(RR=0.5,95%CI:0.3-0.9).Anal swabs of 10 cases were positive for GI norovirus nucleic acid.Conclusion This is an outbreak of acute gastroenteritis caused by GI norovirus with person-toperson transmission,and the contaminated water barrel surface is an important medium of rapid transmission.

关 键 词：诺如病毒 急性胃肠炎 暴发 学校 回顾性队列研究 

分 类 号：R181.81[医药卫生—流行病学]