2023年眉山市东坡区一起托幼机构暑期班GⅡ型诺如病毒暴发疫情的调查  

Investigation of an outbreak of norovirus type GⅡin a summer class of kindergarten in Dongpo District of Meishan City 2023

作　　者：李杰[1] 李慧 李静 邓涛 伍霄雲 汪晴宇 胡昊 LI Jie;LI Hui;LI Jing;DENG Tao;WU Xiaoyun;WANG Qingyu;HU Hao(Meishan Center for Disease Control and Prevention,Meishan 620010,Sichuan Province,China;Dongpo Center for Disease Control and Prevention,Meishan,Meishan 620010,Sichuan Province,China)

机构地区：[1]眉山市疾病预防控制中心,四川眉山620010 [2]眉山市东坡区疾病预防控制中心,四川眉山620010

出　　处：《预防医学情报杂志》2025年第1期20-24,共5页Journal of Preventive Medicine Information

摘　　要：目的对四川省眉山市东坡区某托幼机构暑期班发生的一起GⅡ型诺如病毒暴发疫情进行流行病学调查和分析,为预防和控制此类暴发疫情提供科学依据。方法采用现场流行病学调查方法,对2023年7月眉山市东坡区某托幼机构诺如病毒聚集性疫情制定病例定义,开展病例搜索,通过描述流行病学对病例的症状和三间分布进行描述,运用病例对照研究计算OR值,对危险因素进行分析,用SPSS 21.0软件进行数据处理和统计分析,组间比较采用χ^(2)检验,检验水准设定α=0.05,采集生物和环境标本用RT-PCR方法进行肠道病毒和常见致病菌检测,确定致病原因。结果本次疫情共发现病例21人,均为该托幼机构中一班幼儿,罹患率为47.43%(21/44);临床表现以呕吐(100.00%)、恶心(71.43%)为主,部分幼儿出现发热(42.86%),无腹泻症状;流行曲线提示为点源暴发模式,病例主要集中在7月21日18时至22日6时,占总病例数的80.95%(17/21);男生患病12人,罹患率66.67%(12/18);女生患病9人,罹患率39.13%(9/23),男女生发病差异无统计学意义(χ^(2)=3.06,P=0.08);病例对照研究显示,首发病例呕吐时近距离围观是危险因素(OR=11.25,95%CI:2.53~50.09);14份肛拭子、17份留样食物和29份环境物品涂抹样实验室检测结果中4名患病幼儿检出诺如病毒GⅡ核酸阳性,其余结果均为阴性。结论本次事件为GⅡ型诺如病毒感染导致的暴发疫情,首发病例呕吐时其他幼儿近距离围观是此次疫情的危险因素。Objective Epidemiological investigation and analysis of an outbreak of norovirus type GII in a summer class of a child care institution in Dongpo District of Meishan City in Sichuan province,and to provide a scientific basis for the prevention and control of such outbreaks.Methods The field epidemiological investigation method was used to develop a case definition for an aggregated outbreak of norovirus in a nursery institution in Dongpo District of Meishan City in July 2023,the case search was conducted,the symptoms and trimester distribution of the cases were described by descriptive epidemiology,the OR value was calculated by applying the casecontrol study,the risk factors were analyzed.Data were processed and statistically analyzed by using SPSS 21.0 software,and comparisons between groups were made by usingχ^(2)test,the test level was 0.05;Biological and environmental specimens were collected for detection of enterovirus,and common causative organisms by RT-PCR method,the detection of enteroviruses and common pathogenic bacteria was used to determine the cause of the disease.Results A total of 21 cases were found in this outbreak,all of them were students in the class one of this nursery institutions,with a prevalence rate of 47.43%(21/44);The clinical manifestations of the disease were mainly vomiting(100%),nausea(71.43%),and some of the students had fever(42.86)without diarrhea;The epidemic curve suggests that it was a point-source outbreak pattern,and the cases were mainly concentrated in the period from 18:00 to 6:00 of July 21st to 22nd,accounting for 80.95%(17/21)of the total number of cases;Total 12 boys were ill with 66.67%(12/18),and 9 girls were ill with39.13%(9/23),and the difference was no statistically significant in the incidence of illness between boys and girls(χ^(2)=3.06,P=0.08);The case-control study showed that close spectators at the time of vomiting of the first case was a risk factor(OR=11.25,95%CI:2.53-50.09);Total 4sick toddlers were detected positive for norovirus GⅡnucleic acid

关 键 词：托幼机构 诺如病毒 呕吐 

分 类 号：R512.5[医药卫生—内科学]