一起诺如病毒感染性腹泻疫情的流行病学调查

Epidemiological survey of an epidemic of diarrhea caused by norovirus

  • 摘要: 目的 了解学校诺如病毒感染与发病的流行特征和发病因素,为采取有效防控措施提供数据支撑和理论依据。方法 2021年1月18日-19日,山东某高校某系有20余名学生出现发热、腹痛、腹泻的症状,接到通知后及时前往处置,并将该系477名学生全部纳入调查对象。明确病例定义,使用统一的流调表,严格按照访谈提纲,对病例及其密切接触者开展流行病学调查,详细记录其发病前饮食史、发病时间、临床症状等关键信息,采用实时荧光定量聚合酶链反应(PCR)对采集的呕吐物、肛拭子、食品留样等标本进行检测,利用Excel 2010进行数据录入和统计分析,运用描述性流行病学方法分析疫情流行的时间、空间、人群分布特征。结果 本次疫情是一起由诺如病毒感染引起人传人聚集性暴发疫情,排除食源性和水源性可能,共确诊病例41例,罹患率为8.60%(41/477),其中实验室确诊病例14例、临床确诊病例27例。此外,尚有其他一般不适患者28例,通过采取及时隔离患者、做好环境消毒、保护易感人群等有针对性防控措施后,疫情迅速得到有效控制。结论 该起疫情是诺如病毒感染引起的通过人与人传播的其他感染性腹泻暴发疫情。建议切实加强该高校卫生设施配套建设、严格落实卫生制度并抓好个人卫生习惯养成,做到频发疾病重点防、高发时节提前防、重点人群特殊防。

     

    Abstract: OBJECTIVE To investigate the epidemiological characteristics and pathogenic factors for norovirus infection in a school so as to provide data support and theoretical basis for taking effective prevention measures.METHODS From Jan 18, 2021 to Jan 19, 2021, more than 20 students in a school of Shandong province had symptoms of fever, abdominal pain and diarrhea. After receiving the notice, the author and others went to deal with it in time, and all 477 students in the department were included in the survey. The cases were clearly defined, the unified epidemiological questionnaire was used, the epidemiological survey was also conducted for the cases and their close contacts based on the interview outline, the key information such as the diet history before the onset, disease time and clinical symptoms were recorded in detail. The vomits, anal swabs and foot reserved samples were detected by using real-time fluorescence quantification polymerase chain reaction(PCR). Excel 2010 was used for data entry and statistical analysis, and the characteristics of distribution of time, space and population were analyzed by descriptive epidemiological method.RESULTS This was a person-to-person spread cluster outbreak caused by norovirus infection. The food-borne and water-borne factors were excluded. A total of 41 cases were confirmed, with the attack rate 8.60%(41/477), 14 of whom were diagnosed by clinical laboratory test, 27 were clinically diagnosed. Besides, there were 28 patients with general discomfort. The epidemic was quickly and effectively controlled by taking targeted prevention and control measures such as timely isolation of patients, good environmental disinfection and protection of susceptible population.CONCLUSION This is a person-to-person spread cluster outbreak caused by norovirus infection. It is suggested that the construction of health facilities of the school should be strengthened, the health system should be strictly implemented, the personal health habits should be developed so as to achieve the key prevention of frequent diseases, early prevention in high incidence season and special prevention of key groups.

     

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