摘要
目的对一起大肠埃希菌引起的小学感染性腹泻暴发疫情开展流行病学调查,为类似疫情防控提供依据。方法确定病例定义,开展病例搜索和个案流行病学调查,采用病例对照研究分析危险因素,开展卫生学调查,采集病例标本进行实验室检测。结果 2017年6月15日—6月24日累计发病71例,罹患率为5. 58%。临床表现:腹泻占100%、发热占70. 42%、腹痛占49. 30%、恶心占32. 39%、呕吐占18. 31%等。流行曲线提示为点源暴露模式,病例分布于26个班级。病例对照研究显示,6月16日在学校食用中餐为危险因素(OR=3. 23,95%CI:1. 17~8. 90)。10名病例肛拭子、1名食堂工作人员肛拭子和1份留样食物中检出肠集聚性大肠埃希菌,12份食堂餐炊具涂抹标本中大肠菌群阳性。结论本次疫情为肠集聚性大肠埃希菌引起的感染性腹泻暴发疫情,6月16日学校中餐污染和餐饮具未消毒是危险因素。建议学校加强食品安全管理,严格执行因病缺课登记,及时发现学校传染病聚集性疫情。
Objective To investigate an outbreak of infectious diarrhea caused by Escherichia coli in a school,provide evidences for the prevention and control the similar epidemic.Methods Definition of case,case search and epidemiological investigation were carried out.Risk factors were analyzed by case-control study,and the hygiene information was collected.Samples of cases were collected for laboratory testing.Results During June 15 th to 24 th in 2017,a total of 71 cases were reported in the school,with the attack rate of 5.58%.The main clinical manifestations were diarrhea(100.00%),fever(70.42%),bellyache(49.30%),nausea(32.39%)and vomiting(18.31%).The epidemic curve hinted a point source exposure pattern,and cases distribution in 26 classes.Case-control study showed that eating in school on June 16 was a risk factor for the outbreak(OR=3.23,95%CI:1.17-8.90).Intestinal adhesion Escherichia coli was detected in anal swabs of 10 cases,anal swabs of a canteen worker and a sample food.Coliforms were positive in 12 samples of kitchen utensils smeared.Conclusion The outbreak is an infectious diarrhea caused by Intestinal adhesion Escherichia coli.Contamination of school meals on June 16 and non-disinfection of tableware are risk factors.It is suggested that schools strengthen food safety management,register absence of illness,and detect school infectious disease clustering epidemic timely.
作者
倪朝荣
张晓铭
谢海斌
郑重
潘琼娇
NI Chao-rong;ZHANG Xiao-ming;XIE Hai-bin;ZHENG Zhong;PAN Qiong-jiao(Wenzhou Municipal Center for Disease Control and Prevention,Wenzhou,Zhejiang 325000,China;Center for Disease Control and Prevention in Lucheng District in Wenzhou)
出处
《中国公共卫生管理》
2019年第4期567-570,共4页
Chinese Journal of Public Health Management
关键词
大肠埃希菌
感染性腹泻
暴发
流行病学调查
Escherichia coli
infectious diarrhea
outbreak
epidemiological investigation
