嘉兴市一起诺如病毒胃肠炎暴发疫情的调查  

Investigation on an outbreak of norovirus gastroenteritis in Jiaxing

作　　者：王丹丹 田敏 顾琦俊 冯正磊 郑祎 王梅玉婷 Wang Dandan;Tian Min;Gu Qijun;Feng Zhenglei;Zheng Yi;Wang Meiyuting(Department of Infectious Disease Prevention and Control and Immunology,Nanhu District Center for Disease Control and Prevention,Jiaxing 314001,Zhejiang,China)

机构地区：[1]嘉兴市南湖区疾病预防控制中心传防免疫科,浙江嘉兴314001

出　　处：《国际流行病学传染病学杂志》2021年第6期471-474,共4页International Journal of Epidemiology and Infectious Disease

摘　　要：目的调查嘉兴南湖某酒店一起胃肠炎疫情的暴发原因。方法选择2020年12月26—29日在某酒店就餐宾客及相关服务人员,共170人作为调查对象。采集病例(14份)和食堂从业人员(27份)肛拭子样本、餐厅环境样本(25份)进行检测。随机选择同时进餐,但无任何临床症状的28名宾客作为对照组。采用病例-对照研究分析此次暴发疫情的危险因素。结果共搜集临床病例25例,实验室确诊病例7例,均为12月26日晚在某酒店5号厅参加宴席人员,罹患率为18.82%(32/170)。临床症状以呕吐、腹痛、腹泻为主。流行曲线提示本次疫情为点源暴露。32例病例中,男性占28.13%(9例),女性占71.87%(23例)。病例对照研究发现,病例组对蒜蓉粉丝蒸扇贝和白灼基围虾的暴露率分别为78.13%和81.25%,高于对照组的32.14%和57.14%,差异有统计学意义[OR(95%CI)=7.540(2.378~23.904)和3.250(1.018~10.379)]。8份病例肛拭子样本中7份为诺如病毒GⅡ型阳性,食堂从业人员27份肛拭子样本中1份(传菜员)为诺如病毒GⅡ型阳性。结论该疫情为GⅡ型诺如病毒感染引起的胃肠炎暴发疫情,可能通过传菜员污染菜品传播。Objective To investigate an outbreak of gastroenteritis in a restaurant in Nanhu District of Jiaxing City.Methods A total of 170 dining guests and related service personnel of one restaurant from December 26 to 29,2020 were selected.Anal swabs of patients(14 samples)and employees(27 samples)and environmental samples(25 samples)were collected for testing.A total of 28 guests with no clinical features were randomly selected as control group.The risk factors of the outbreak were analyzed by a case-control study.Results A total of 25 clinical cases and 7 laboratory confirmed cases were collected.All the cases attended in the banquet in hall 5 of the restaurant on December 26.The incidence rate was 18.82%(32/170).The main clinical symptoms were vomiting,abdominal pain and diarrhea.The epidemic curve indicated that the outbreak was point source exposure.Among 32 cases,the proportions of males and females were 28.13%(9 cases)and 71.87%(23 cases),respectively.Case-control study showed that the exposure rates to steamed scallops with minced garlic and vermicelli were 78.13%and 81.25%in the case group,which were significantly higher than those of 32.14%and 57.14%in the control group(OR=7.540,95%CI:2.378-23.904;OR=3.250,95%CI:1.018-10.379).Seven of 8 anal swab samples from patients were positive for GⅡnorovirus,and 1 of 27 anal swab samples from employees was positive for GⅡnorovirus.Conclusions It is an outbreak of gastroenteritis caused by GⅡnorovirus,which may be transmitted through contaminated dishes by the waiter.

关 键 词：胃肠炎 诺如病毒 病例对照 食源性疾病 聚集性疫情 点源暴露 

分 类 号：R512.5[医药卫生—内科学] R181.8[医药卫生—临床医学]