2022年北京市一起餐饮公司配餐引起的诺如病毒感染急性胃肠炎暴发疫情调查  

Epidemiological investigation of an acute norovirus gastroenteritis outbreak caused by a catering company in Beijing,2022

作　　者：张文增[1] 李红霞[1] 皮海伦[1] 史继新[1] 何朝[1] 彭涛[1] ZHANG Wen-zeng;LI Hong-xia;PI Hai-lun;SHI Ji-xin;HE Chao;PENG Tao(Shunyi District Center for Disease Prevention and Control,Beijing 101300,China)

机构地区：[1]北京市顺义区疾病预防控制中心,101300

出　　处：《首都公共卫生》2022年第6期380-383,共4页Capital Journal of Public Health

基　　金：高层次公共卫生技术人才建设项目培养计划(编号:学科骨干-01-005)。

摘　　要：目的调查2022年北京市一起由于餐饮公司配餐引起的诺如病毒感染急性胃肠炎暴发疫情,分析可能的危险因素,探讨疫情处置经验。方法采用现场流行病学方法开展调查,描述性流行病学方法描述病例的临床症状和三间分布,病例对照研究分析疫情暴发的原因,采集病例及相关人员肛拭子和环境样本进行肠道病毒和肠道致病菌检测。结果共搜索到49例疑似病例,涉及2家单位,其中A单位19例,罹患率为6.5%;B单位30例,罹患率为19.6%。B单位罹患率高于A单位(χ^(2)=20.831,P<0.001)。病例临床表现以腹泻、呕吐、恶心为主,分别占49.0%、44.9%和34.7%,无重症和死亡病例;流行曲线提示为点源暴露模式;病例分布无明显的空间聚集性。发病年龄20~49岁,中位数为25岁。病例对照研究结果显示食用24日早餐为本起疫情发生的危险因素(OR=3.41,95%CI:1.09~10.67)。39件肛拭子样本、3件环境涂抹样本和1件留样食品(24日早餐杂粮粥)检出GⅠ组诺如病毒。结论本次事件是由GⅠ组诺如病毒引起的急性胃肠炎暴发疫情。供餐企业配送的24日早餐中的杂粮粥被GⅠ组诺如病毒污染,2家集体单位人员食用后导致疫情暴发。建议加强供餐企业食品安全工作,从而预防食品安全事件的发生。Objective To analyze the epidemiological characteristics and identify the risk factors of an acute norovirus gastroenteritis outbreak caused by a catering company in Beijing,2022,and explore the experience of the epidemic response.Methods Field epidemiology method was carried out.The clinical manifestations and the distribution of the cases were described with descriptive epidemiological method,and a case-control study was used to find out the cause of the outbreak.Laboratory tests of enteroviruses and bacterial pathogens were performed by using anal swabs of the patients and environment samples.Results A total of 49 cases were identified,involving with 2 units.Among them,there were 19 cases in unit A,with an attack rate of 6.5%;and there were 30 cases in unit B,with an attack rate of 19.6%.The attack rate of B unit was higher than that of A unit(χ^(2)=20.831,P<0.001).The main clinical manifestations of the cases were mainly diarrhea,vomiting and nausea,accounting for 49.0%,44.9%and 34.7%,respectively.There was no severe cases or deaths reported.The epidemic curve suggested that there was a point source exposure and there was no obvious spatial clustering in the distribution of cases.The age of onset was 20 to 49 years old,with a median of 25 years old.The result of the case-control study showed that eating breakfast on the 24th was associated with illnessa(OR=3.41,95%CI:1.09-10.67).GⅠnorovirus were detected in 39 anal swabs,3 environmental smear specimens and 1 reserved food(the 24th breakfast cereal porridge).Conclusions It was an outbreak of acute gastroenteritis caused by GⅠnorovirus.The miscellaneous grain porridge in the breakfast delivered by the catering company on the 24th was contaminated with GⅠnorovirus,and the outbreak of the epidemic occurred after consumption by personnel in the two units.It is recommended that further measures should taken to strengthen the food safety work of catering enterprises to prevent the occurrence of food safety incidents.

关 键 词：诺如病毒 食源性疾病 暴发疫情 流行病学调查 

分 类 号：R512.5[医药卫生—内科学] R183[医药卫生—临床医学]