学校诺如病毒感染性疫情传播能力评估和控制措施效果评价  

Assessment on transmission capacity of norovirus infection and effect of control measures in schools

作　　者：许玉成[1] 张瑞银 周志峰[1] 钟剑明[1] 梁静[1] 郭聪锐[1] 赵梦蓝 李学云[1] XU Yu-cheng;ZHANG Rui-yin;ZHOU Zhi-feng(Office of Emergency Response,Futian District Center for Disease Control and Prevention,Shenzhen,Guangdong Province 518000,China;不详)

机构地区：[1]深圳市福田区疾病预防控制中心应急办公室,广东深圳518040 [2]南方医科大学附属深圳妇幼保健院

出　　处：《中国公共卫生》2021年第4期702-705,共4页Chinese Journal of Public Health

基　　金：深圳市福田区公益类科研项目(FTWS2020072)。

摘　　要：目的对学校诺如病毒感染性疫情传播能力进行估算,对停课措施和呕吐物处理进行效果评估,为制定疾病管理策略和控制措施提供依据。方法选取2015—2019年深圳市福田区学校发生的诺如病毒感染性疫情53起,采用SEIR动力学模型对疫情数据进行模拟,计算疫情的基本再生系数R0来评价疫情传播能力,计算疫情的累计罹患率和疫情持续时间来评价控制措施的防控效果。结果学校诺如病毒感染性疫情无干预情况下基本再生系数R0为11.54(10.52,13.60),不同年份、流行季节与非流行季节、不同类型学校诺如病毒感染性疫情的基本再生系数R0差异均无统计学意义(P>0.05);停课3 d的疫情累计罹患率明显低于不采取停课措施的疫情(Z=8.875,P<0.001),疫情持续时间明显短于不采取停课措施的疫情(Z=8.172,P<0.001);有学生在教室内呕吐的疫情R0高于没有学生在教室内呕吐的疫情(Z=5.523,P<0.001),处理呕吐物时其他学生离开教室的疫情R0低于学生没有离开教室的疫情(Z=2.893,P=0.003)。结论学校诺如病毒感染性疫情传播能力强,采取停课措施和当教室内有学生出现呕吐症状时将其他学生带离教室能有效减低疫情的传播蔓延。Objective To estimate the transmission capacity of norovirus infection and to evaluate the effect of measures for norovirus infection epidemic control in schools for providing evidences to the development of relevant management strategies and control measures. Methods From Shenzhen Municipal Information System for Disease Control and Prevention, we extracted data on 53 epidemics of norovirus infection from 2015 through 2019 in schools in Futian district of Shenzhen city. The susceptible-exposed-infectious-removed(SEIR) dynamics model was used to simulate the collected data for the calculation of basic regeneration coefficient(R0) of the epidemics to evaluate the epidemic transmission capacity and calculations of cumulative incidence rate and duration of the epidemics to evaluate the effect of control measures. Results For the occurred epidemics under the condition without any intervention, the basic regeneration coefficient(R0) of norovirus infection was 11.54(25% percentile: 10.52, 75% percentile: 13.60). There was no significant difference in R0 between different years, between epidemic season and non-epidemic season, and among different types of schools(all P > 0.05).Compared to the outbreaks in schools without class suspension, significantly lower cumulative incidence(Z = 8.875, P < 0.001)and shorter epidemic duration(Z = 8.172, P < 0.001) were observed for the outbreaks in the schools with 3-day class suspension. The R0 of the outbreaks with the infected students vomiting in classrooms was higher than that of the outbreaks without the students vomiting in classrooms(Z = 5.523, P < 0.001);the R0 of the outbreaks in which the attendant students being asked to leave the classrooms when conducting disinfection treatment on the infected students′ vomitus was significantly lower than the outbreaks in which the students being not asked to leave the classrooms when performing the disinfection treatments(Z = 2.893, P = 0.003). Conclusion The transmission capacity of a norovirus infection outbreak in schools is high

关 键 词：诺如病毒 动力学模型 基本再生系数 控制措施 效果评价 

分 类 号：R183.4[医药卫生—流行病学]