摘要
目的 探索一起学校急性胃肠炎暴发的规模、病原体和传播危险因素,提出针对性防控措施。方法 通过描述性流行病学、现场卫生学调查和回顾性队列研究,进行单因素分析、Log-binomial回归模型、叉生分析筛选可疑危险因素,采集肛拭子和粪便样本开展实验室检测。结果 共发病24例,其中疑似病例9例,临床诊断病例15例。中位年龄为12岁,男女罹患率无差异,均为同班学生,班级罹患率48.00%(24/50)。患者主要症状为腹痛、腹泻和恶心。首发病例10月5日发病,10月7日开始出现二代病例,呈现“人传人+点源暴发”模式。患者肛拭子(18份)和粪便样本(2份)肠道38种病原检测结果均为阴性,宏基因组二代测序未发现可疑病原体。叉生分析结果显示,体育课上与病例打篮球且上完体育课没洗手是本次腹泻暴发疫情传播的危险因素(RR=8.80,95%CI:1.88~41.01),存在正交互作用(S=1.088,AP=7.16%,RERI=0.63)。结论 这可能是一起学校病毒性腹泻暴发,应教育学生避免带病上课,培养学生良好的手卫生习惯。
Objective To explore the epidemiological characteristics,pathogens and transmission risk factors of an acute gastroenteritis outbreak occurred in a school,so as to propose preventive and control measures.Methods Field epidemiology method was carried out.The descriptive epidemiological method was used for analyzing clinical manifestations and the distribution of the cases,and retrospective cohort study was conducted to find out the cause of this outbreak.Univariate analysis,log-binomial regression model and crossover analysis were further used for statistical analysis.Anal swabs and fecal samples of the patients were collected for laboratory testing.Results A total of 24 cases were reported(all of which were students of the same class),including 9 suspected cases and 15 clinically diagnosed cases.The median age was 12 years.The class attack rate was 48.00%(24/50),the difference of attack rate between boys and girls was not significant.The main clinical manifestations of the cases were abdominal pain,diarrhea,and nausea.The first case occurred on October 5,and the second generation of cases began to appear on October 7,indicating a human-to-human+point source outbreak model.The detection results of 38 types of intestinal pathogens in collected anal swabs and fecal samples were negative,and no suspicious pathogens were found by metagenomics next-generation sequencing.Cross-analysis results indicated that playing basketball with cases during physical education classes,without washing hands afterward,was a risk factor for the diarrhea outbreak(RR=8.80,95%CI:1.88-41.01),showing a positive interaction(S=1.088,AP=7.16%,RERI=0.63).Conclusion This probably was a diarrhea outbreak caused by viral in the school.Avoiding attending classes with illness should be advocated for students,and at the same time good hand hygiene habits should be cultivated.
作者
洪烈城
陈丽华
陈亿雄
尹江伟
梁丽君
李苑
Hong Liecheng;Chen Lihua;Chen Yixiong;Yin Jiangwei;Liang Lijun;Li Yuan(Department of Health Risk Factors Prevention,Control and Supervision,Public Health Service Center,Baoan District,Shenzhen,Shenzhen Guangdong 518102,China;Department of Preventive Care,Shenzhen Hospital of Guangzhou University of Chinese Medicine,Shenzhen Guangdong 518034,China;Department of Infectious Disease Prevention and Control,Baoan District Center for Disease Prevention and Control,Shenzhen Guangdong 518101,China;Department of Quality and Technology,Guangdong Center for Disease Prevention and Control,Guangzhou Guangdong 511430,China)
出处
《遵义医科大学学报》
2024年第12期1229-1234,共6页
Journal of Zunyi Medical University
基金
广东省重点领域研发计划项目(NO:2022B111102006)。
关键词
学校
急性胃肠炎
暴发
现场流行病学
school
acute gastroenteritis
outbreak
field epidemiology
