学校流感暴发疫情环境病毒感染特征分析  

Characteristics of Environmental Virus Infection During Influenza Outbreaks in Schools

作　　者：王传宝 季圣翔[1] 李成伟 刘祥亮 蒋春云 刘秀芳 刘建成 段倩倩 李正杰 宋昊泽 徐启睿 吴芳芳[2] 孙桂玲[2] 尹德清[1] WANG Chuanbao;JI Shengxiang;LI Chengwei;LIU Xiangliang;JIANG Chunyun;LIU Xiufang;LIU Jiancheng;DUAN Qianqian;LI Zhengjie;SONG Haoze;XU Qirui;WU Fangfang;SUN Guiling;YIN Deqing(Linyi Center for Disease Control and Prevention,Linyi 276000,China;Linyi People's Hospital,Linyi 276000,China)

机构地区：[1]临沂市疾病预防控制中心,临沂276000 [2]临沂市人民医院,临沂276000

出　　处：《病毒学报》2024年第6期1378-1383,共6页Chinese Journal of Virology

摘　　要：本研究对发生在学校内暴发疫情的教室环境物品表面和感染病例的流感病毒(Influenza virus,IV)进行核酸检测,探究可能造成教室环境污染的影响因素,评估学生常规活动接触物品的传播风险,并提供间接感染流感的病毒分离证据,为学校流感暴发疫情处置提供策略依据。本研究将60起中小学流感暴发疫情纳入实验,结果显示每起疫情IV阳性检出百分数(OR=0.697,95%CI:0.529~0.198)和每起疫情IV阳性检出病例Ct值均值(OR=1.082,95%CI:1.014~1.154)在α=0.05的水平上,是暴发疫情环境中IV检出的独立影响因素。共采集暴发疫情的场所环境16种物表拭子样本470份,共检出IV阳性76份,检出率为16.17%;检出率最高的物表为门把手表面(26.67%);检出率最低的物表为墙壁、黑板和空调表面(0.00%)。16种物表核酸检测检出阳性13种,Ct值均值最低的物表为饮水机表面(30.06);Ct值均值最高的物表为窗台表面(39.55);墙壁、黑板和空调表面均未检出(Ct值均值>45)。对76份核酸阳性样本进行病毒分离,分离毒株2株,分离率2.63%。一株从拖把表面样本中分离;另一株为扫帚表面样中本分离。本研究结果显示,学校流感暴发疫情环境中的病毒检出与流感样病例(Influenza-like illness,ILI)的IV阳性检出率正相关,与阳性病例样本的Ct值大小负相关,两者是影响学校暴发疫情环境中病毒检出情况的独立因素;流感暴发教室环境内的物品按照接触频率的大小存在者病毒污染情况的差异;环境来源样本病毒分离率低,在做好环境消毒的基础上,通过物表的间接接触造成感染的可能性较小,常规消毒可对校内流感暴发疫情的传播起到减缓作用。We wished to:(i)evaluate the transmission risk of influenza viruses(IVs)by students touching items in a classroom;(ii)provide evidence of IV isolation during indirect infection;(iii)explore the influencing factors that may cause environmental pollution in the classroom;and(iv)provide a strategic basis for the management of influenza outbreaks in schools.We detected the nucleic acids(NAs)of IVs on the surfaces of items in the classroom as well as in infected children in school.We assessed 60 outbreaks of influenza in primary and secondary schools.The percentage of IV-positive cases in each outbreak(odds ratio[OR]=0.697,95%confidence interval[CI]:0.529–0.198)and the mean Ct value of IV-positive cases in each outbreak(OR=1.082,95%CI:1.014–1.154)atα=0.05 were the independent influencing factors for IV detection in the outbreak environment.A total of 470 environmental-swab samples of 16 types of objects were collected from outbreak sites,and 76 were positive for IV(16.17%).The surface with the highest prevalence of NA detection was the door-handle(26.67%).The lowest prevalence of NA detection was on the surfaces of walls,blackboards and air-conditioning systems(0.00%).Thirteen types of NA detection were positive in 16 kinds of surfaces.The surface with the lowest mean Ct value was the water dispenser(30.06).The surface with the highest mean Ct value was the windowsill(39.55).NAs from IVs were not detected on the surfaces of walls,blackboards or air-conditioning systems(mean Ct>45).Virus isolation was undertaken on 76 NA-positive samples,and two strains were isolated(2.63%).One strain was isolated from a mop surface;the other strain was isolated from a broomstick surface.Virus detection in the environment of influenza outbreaks in schools was positively correlated with the prevalence of positive detection of influenza-like illness,and negatively correlated with the Ct value of IV-positive samples.Both were independent factors affecting the virus detection in the environment of outbreaks in schools.According to the

关 键 词：学校 流感暴发 流感病毒 环境 

分 类 号：R373.1[医药卫生—病原生物学]