西双版纳州景洪市1起诺如病毒感染性腹泻暴发疫情的流行病学调查  

Epidemiological investigation of an outbreak of norovirus infectious diarrhea in Jinghong City of Xishuangbanna Prefecture

作　　者：戚艳波[1] 李海艳 何荆 玉罕老 郑尔达 李园园 QI Yanbo;LI Haiyan;HE Jing;YU Hanlao;ZHENG Erda;LI Yuanyuan(Epidemic Surveillance/Public Health Emergency Response Centre,Yunnan Center for Disease Control and Prevention,Kunming,Yunnan 650022,China;Department of Acute Infectious Disease Control,Xishuangbanna Center for Disease Control and Prevention,Xishuangbanna,Yunnan 666100,China;Department of Acute Infectious Disease Control,Jinghong Center for Disease Control and Prevention,Xishuangbanna,Yunnan 666100,China)

机构地区：[1]云南省疾病预防控制中心疫情监测/突发公共卫生事件处置中心,云南昆明650022 [2]西双版纳傣族自治州疾病预防控制中心急性传染病控制科,云南西双版纳666100 [3]景洪市疾病预防控制中心急性传染病控制科,云南西双版纳666100

出　　处：《职业与健康》2024年第21期3000-3003,共4页Occupation and Health

摘　　要：目的对景洪市1起因诺如病毒感染引起的暴发疫情进行调查分析,为云南省诺如病毒感染防治提供参考依据。方法利用调查问卷、面对面访谈的方式调查2023年4月22日—5月3日出现症状患者及相关人员的流行病学特征、临床表现,采用描述流行病学方法,描述病例发病的时间、人群和空间分布;对发病人员就餐地某景区餐厅开展现场卫生学调查,包括从业人员健康情况、就餐环境和采供水设备;采集病例、旅行团游客、餐饮从业人员肛拭子、可疑水样、物体表面涂抹式子、食品采用微生物快速富集系统对样品进行实验室检测。结果共搜索到符合病例定义病例186例,病例分布于22个旅行团;男性44例,女性142例,男女比例1∶3.23,发病最小年龄6岁,最大年龄78岁。某景区餐厅4名工作人员其家属近1周出现腹泻、呕吐症状;现场查看到防蝇设施但未开启使用;水果间消毒紫外线灯上无灯管;景区取水点与污水排放点距离很近,并位于污水排放点下游。共采集346份肛拭子样本中85份为诺如病毒阳性。结论本起事件为1起诺如病毒污染水源引起的感染性腹泻暴发事件,系某景区自备生活用水水源受到诺如病毒污染所致。建议加强病例诊治隔离,及时开展水源消毒、暂停该景区餐厅营业,多渠道、多平台开展大众健康宣传工作,以阻遏疫情蔓延和再发。Objective To investigate and analyze an outbreak caused by Norovirus infection in Jinghong City,and provide reference for the prevention and treatment of Norovirus infection in Yunnan Province.Methods The epidemiological characteristics and clinical manifestations were collected by conducting questionnaires and face-to-face interviews to patients and related persons who developed symptoms from April 22 to May 3,2023.Descriptive epidemiological methods were used to describe the time,population,and spatial distribution of the cases.Conduct on-site hygiene investigation on a restaurant in a scenic area where the patient dined,including the health status of employees,dining environment,and water supply equipment.Collect cases,travel group tourists,catering staff anal swabs,suspicious water samples,surface coating of objects,and food samples for laboratory testing using a microbial rapid enrichment system.Results A total of 186 cases were found that met the case definition,distributed among 22 travel groups.There were 44 males and 142 females,with a male-to-female ratio of 1∶3.23,and the minimum age was 6 years and the maximum age was 78 years.Four staff members and their families of a restaurant in a certain scenic area had suffered from diarrhea and vomiting in the past week.Fly prevention facilities were found on site but were not activated for use.There was no light tube on the ultraviolet disinfection lamp in the fruit room.The water intake point in the scenic area was very close to the sewage discharge point and located downstream of the sewage discharge point.Out of 346 anal swab samples collected,85 were positive for norovirus.Conclusion This incident is an outbreak of infectious diarrhea caused by Norovirus contamination of a water source,which was caused by Norovirus contamination of a self-provided domestic water source in a certain scenic area.It is recommended to strengthen the diagnosis,treatment,and isolation of cases,promptly carry out water source disinfection,suspend the operation of restaurants in

关 键 词：诺如病毒 暴发疫情 流行病学特征 

分 类 号：R181.81[医药卫生—流行病学]