2020年九江市浔阳区首起幼儿园GⅡ型诺如病毒急性胃肠炎暴发疫情调查分析  

Investigation and analysis of the first kindergarten type GⅡnorovirus acute gastroenteritis outbreak in Xunyang district,Jiujiang city in 2020

作　　者：殷文渊 杜艳红[1] 陈忠伯 YIN Wen-yuan;DU Yan-hong;CHEN Zhong-bo(Center for Disease Control and Prevention of Xunyang Distric,Jiujiang,Jiangxi 332000)

机构地区：[1]九江市浔阳区疾病预防控制中心,江西九江332000

出　　处：《赣南医学院学报》2023年第11期1137-1141,共5页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:通过调查处置2020年浔阳区某幼儿园1起GⅡ型诺如病毒急性胃肠炎暴发疫情,查找疫情暴发原因、传播途径,评估预防控制措施效果,为同类疫情的预防控制提供参考。方法:运用现场流行病学调查方法,描述病例的临床表现及三间分布,分析疫情暴发的原因;采集病例及环境标本进行诺如病毒核酸检测,佐证推断结果。结果:2020年9月7日至10日,累计搜索病例31例,均为幼托儿童,幼儿园罹患率4.40%(31/704);病例临床表现以呕吐(96.77%)、发热(67.74%)、腹痛(64.52%)为主,均为轻症;流行曲线为典型的点源传播;不同性别儿童罹患率比较差异无统计学意义(χ^(2)=1.977,P=0.16);中(2)班发病人数最多,罹患率达60.98%(25/41),各班级罹患率差异有统计学意义(χ^(2)=76.58,P<0.05);二层发病人数最多,共28例,占病例总数90.32%。幼儿园一至三层罹患率分别为0(0/146)、8.72%(28/321)、1.27%(3/237),各楼层罹患率差异有统计学意义(χ^(2)=26.49,P<0.05)。采集幼儿园环境标本6份,患儿呕吐物标本1份,咽拭子标本1份,肛拭子标本4份,其中有3例患儿肛拭子检出GⅡ型诺如病毒,其余标本阴性。结论:本次疫情是GⅡ型诺如病毒引起的急性胃肠炎暴发疫情,密切接触是主要危险因素,未规范消毒处置和未及时隔离病例是本次疫情暴发的主要原因。Objective:To investigate the response to an outbreak of acute gastroenteritis of type GⅡnorovirus in a kindergarten in Xunyang district in 2020,trying to find out the cause and transmission route of the epidemic,to evaluate the effect of prevention and control measures,and to provide reference for the prevention and control of similar outbreaks.Methods:The clinical manifestations and dstribution of the three of the cases were described and the causes of the outbreak were analyzed by field epidemiological investigation.Cases and environmental specimens were collected for nucleic acid detection of norovirus to support the inferred results.Results:From September 7th to 10th,2020,a total of 31 cases were found,all of which were children in kindergartens,with an attack rate of 4.4%(31/704).The clinical manifestations of the cases were mainly vomiting(96.77%),fever(67.74%),abdominal pain(64.52%),all of which were mild.The epidemic curves suggested a point source exposure.The incidence rate of children of different genders was with no statistical significance(χ^(2)=1.977,P=0.16).The middle class 2 had the most cases,accounting for 60.98%(25/41);the incident rates among the classes were with statistical significance(χ^(2)=76.58,P<0.05).The second floor had the largest number of cases,with 28 cases,accounting for 90.32%of the total number of cases.The attack rates of the 1st to 3rd floors of the kindergarten were 0(0/146),8.72%(28/321),and 1.27%(3/237),respectively,and there was a statistically significant difference in the attack rate among different floors(χ^(2)=26.49,P<0.05).Altogether 6 environmental smear specimens,1 vomitus specimen,1 throat swab specime,4 anal swab specimens were collected.GⅡnorovirus was detected in anal swabs from 3 cases,and the results of other specimens were negative.Conclusion:This outbreak was an outbreak of acute gastroenteritis caused by GⅡnorovirus.Close contact was the main risk factor.The main cause of this outbreak was the failure to handle with standardized disinfection and t

关 键 词：诺如病毒 急性胃肠炎 流行病学调查 

分 类 号：R573.3[医药卫生—消化系统]