摘要
目的 分析一起学校诺如病毒感染暴发疫情的流行特点及暴发原因,探讨疫情处置经验。方法 采用描述性流行病学方法分析病例临床及流行病学特征,采用病例对照研究和回顾性队列研究探索暴发危险因素,采集25份病例肛拭子及12份环境标本,采用RT-PCR方法检测诺如病毒核酸。结果 本次疫情持续23天,累计病例63例,涉及18个班级,罹患率为4.2%。病例均为学生,年龄6~12岁,其中男性38例,女性25例,男女比例为1.5∶1。临床表现为呕吐(87.3%)、腹痛(74.6%)、腹泻(41.3%)、发热(17.5%)。首例病例呕吐物产生的气溶胶造成班级点源暴发,队列研究显示距离呕吐物≤1.5米暴露组罹患率高于>1.5米非暴露组(RR=2.000,95%CI:1.056~3.789);全校54.0%病例曾在校内呕吐,疫情扩散的危险因素是接触病人、接触呕吐物、混班午晚托。16份病例肛拭子和1份环境样本(首例桌椅表面)诺如病毒核酸阳性,基因分型均为GⅡ.P16-GⅡ.2。结论 本起暴发疫情由诺如病毒感染引起,规范处理呕吐物和环境消毒、取消混班活动是控制诺如病毒暴发疫情的关键。
Objective To analyze the epidemiological characteristics and causes of an outbreak of norovirus infection in schools,and explore the experience in the management of the outbreak.Methods Descriptive epidemiological methods were used to analyze clinical and epidemiological characteristics of the cases;case-control studies and retrospective cohort studies were conducted to explore risk factors for the outbreak,and 28 anal swabs for the cases and environmental samples were collected for detection of norovirus nucleic acid by RT-PCR.Results The outbreak lasted for 23 days,with a total of 63 cases reported,involving 18 classes,and the attack rate was 4.2%.All the cases were students aged from 6 to 12 years,including 38 males and25 females,with a male-to-female ratio of 1.5∶1.The clinical manifestations were vomiting(87.3%),abdominal pain(74.6%),diarrhea(41.3%) and fever(17.5%).The aerosol produced by the vomit of the first case caused point-source outbreak in a class.Cohort study showed that attack rate in the group exposed to vomit ≤1.5 m was higher than that in the group exposed to vomit >1.5 m(RR=2.000,95%CI:1.056-3.789).In the school,54.0% of the cases had vomiting,and the risk factors for the spread of the outbreak were contact with patients,contact with vomitus,mixed midday care and evening care.The test results of 16 anal swabs and 1 environmental sample(desk and chair surface of the first case) were positive for nucleic acid of norovirus,and the genotyping was G Ⅱ.P16-G Ⅱ.2.Conclusion The outbreak was caused by norovirus.Standardizing the treatment of vomit and environmental disinfection,and cancelling class-mixed activities were the key to control the outbreak of norovirus.
作者
萧松建
尹锡玲
林新天
刘东妹
吴燕飞
阮峰
XIAO Songjian;YIN Xiling;LIN Xintian;LIU Dongmei;WU Yanfei;RUAN Feng(Zhuhai Center for Disease Control and Prevention,Zhuhai,Guangdong 519000,China;Fogang Center for Disease Control and Prevention;Guangming Center for Disease Control and Prevention)
出处
《河南预防医学杂志》
2022年第10期768-771,共4页
Henan Journal of Preventive Medicine
基金
广东省医学科学技术研究基金项目(A2021021)
珠海市卫生健康局科技项目(20191207A010018)。
关键词
诺如病毒
暴发
调查
学校
Norovirus
Outbreak
Investigation
School
