一起诺如病毒感染引起的校园突发公共卫生事件的调查  

Epidemiological survey on a school public health emergency event caused by norovirus infection

作　　者：陆献蒿 田红艳[1] 农智[1] 陆夏瑜 易斌 LU Xianhao;TIAN Hongyan;NONG Zhi;LU Xiayu;YI Bin(Department of Disease Control,Baise Center for Disease Prevention and Control,Baise 533000,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]百色市疾病预防控制中心疾病控制科,广西百色533000

出　　处：《微生物学免疫学进展》2024年第4期56-60,共5页Progress In Microbiology and Immunology

摘　　要：目的对百色市某高中一起诺如病毒(norovirus)感染暴发疫情的流行特征及流行因素进行调查,为学校诺如病毒感染疫情提供防控依据。方法根据病例定义开展搜索,采用描述性流行病学方法对病例特征进行三间分布描述,收集病例的临床数据,采集可疑环境样本及具有代表性病例的生物标本进行实验室检测,结合现场卫生学调查分析暴发原因。结果2021年1月20—28日,本次疫情共累计报告病例205例,其中疑似病例189例,确诊病例11例,隐性感染者5例。临床症状主要以腹泻(90.50%)、呕吐(35.50%)为主,无重症及死亡病例。男性罹患率5.85%(116/1984)高于女性罹患率3.74%(89/2381)。高中3个年级学生均有病例报告,但高三罹患率最高,为10.39%,发病风险是高一、高二学生的5.90倍(95%CI:4.473~7.778)。对72份肛拭子、外环境涂抹标本进行诺如病毒GI型、GII型实验室检测,检出16份肛拭子呈GⅡ型诺如病毒核酸阳性。流行曲线显示人传人模式,1月29日学生放假全部离校后无病例报告。结论本事件为一起GⅡ型诺如病毒感染导致的学校暴发疫情,学校未及时采取有效控制措施,最终导致学校暴发疫情的暴发。应加强病例排查及管理,规范吐泻物消毒处理,避免类似事件再次发生。Objective To investigate the epidemiological characteristics and factors of an outbreak of norovirus infection in a high school in Baise City,so as to provide evidences for prevention and control of norovirus infection in schools.Methods The search was carried out according to the definition of the case,and the descriptive epidemiological method was used to describe the time,the space and the crowd distribution of the case characteristics.The clinical manifestations of the cases,suspicious environmental samples and biological samples of representative cases were collected for laboratory testing,and the causes of the outbreak were analyzed in combination with the field hygienic investigation.Results From January 20 to 28,2021,a total of 205 cases were reported in this epidemic,including 189 suspected cases,11 confirmed cases and 5 latent infections.The main clinical symptoms were diarrhea(90.50%)and vomiting(35.50%).There were no severe and death cases.The incidence of male(116/1984,5.85%)was higher than that of female(89/2381,3.74%).Cases were reported in all three grades of the senior high school,but mainly in the third grade,with the incidence of 10.39%.The incidence risk of the third grade was 5.90 times higher than that of the first and second grade(95%CI:4.473-7.778).Norovirus genogroups were detected in 72 anal swabs and smeared samples,among which 16 anal swabs were positive for GII norovirus.The epidemic curve showed a human to human transmission mode.No case was reported after all students left school on January 29.Conclusion This incident was a school outbreak caused by GII norovirus infection.The school did not take effective control measures in time,which eventually led to the outbreak of the school epidemic.Thus it is essential to strengthen the case investigation and management,as well as standardize the disinfection treatment of vomiting and diarrhea to avoid similar events.

关 键 词：诺如病毒 感染性腹泻 疫情暴发 现场流行病学 学校卫生 食源性疾病 隐性感染 

分 类 号：R378[医药卫生—病原生物学]