吴定国, 杨娟, 吴迪. 2023年贵州省铜仁市松桃县某中学一起诺如病毒感染引起的急性胃肠炎聚集性疫情调查[J]. 凯发娱乐加盟代理, 2024, 39(1): 115-120. DOI: 10.3784/jbjc.202306020262
引用本文: 吴定国, 杨娟, 吴迪. 2023年贵州省铜仁市松桃县某中学一起诺如病毒感染引起的急性胃肠炎聚集性疫情调查[J]. 凯发娱乐加盟代理, 2024, 39(1): 115-120. DOI: 10.3784/jbjc.202306020262
Wu Dingguo, Yang Juan, Wu Di. Investigation of an acute gastroenteritis epidemic caused by norovirus infection in a middle school in Songtao, Tongren, Guizhou, 2023[J]. Disease Surveillance, 2024, 39(1): 115-120. DOI: 10.3784/jbjc.202306020262
Citation: Wu Dingguo, Yang Juan, Wu Di. Investigation of an acute gastroenteritis epidemic caused by norovirus infection in a middle school in Songtao, Tongren, Guizhou, 2023[J]. Disease Surveillance, 2024, 39(1): 115-120. DOI: 10.3784/jbjc.202306020262

2023年贵州省铜仁市松桃县某中学一起诺如病毒感染引起的急性胃肠炎聚集性疫情调查

Investigation of an acute gastroenteritis epidemic caused by norovirus infection in a middle school in Songtao, Tongren, Guizhou, 2023

  • 摘要:
    目的  调查2023年2月铜仁市松桃县某中学一起急性胃肠炎聚集性疫情,分析其临床症状、流行病学特征和可能危险因素,为疫情防控提供参考。
    方法  采用现场流行病学方法开展调查,通过描述性流行病学方法描述病例的临床症状和三间分布,运用病例对照研究分析疫情暴发的危险因素,采集病例和非病例的肛拭子、呕吐物、环境涂抹物和食堂留样食品,采用实时荧光定量反转录–聚合酶链式反应(RT-PCR)方法检测诺如病毒和常见致病菌。
    结果  本次疫情中病例包括12名学生和2名教师,罹患率分别为6.70%(12/179)和 5.13%(2/39);病例涉及4个班级,主要分布在九(1)班,罹患率20.83%(5/24),男女性罹患率差异无统计学意义(χ2=3.470,P=0.062);病例症状以腹泻(100.00%)、腹痛(78.57%)、恶心(71.43%)和呕吐(42.86%)为主;首末例病例发病时间分别为2月24日12:00和3月2日18:00,发病高峰集中在2月26 — 28日,流行曲线显示为增值人–人模式。 1名学生和2名老师的肛拭子标本中检出2份GⅠ组诺如病毒和1份GⅡ组诺如病毒。 病例对照研究显示,71.43%(10/14)的病例近距离暴露过患者呕吐物或粪便[比值比(OR)=32.500,95%置信区间(CI):3.127~337.813,P<0.001]和接触同类患者(OR=6.250,95%CI:1.213~32.214,P<0.001)为此次疫情的危险因素,其余危险因素与发病关联无统计学意义。
    结论  本次疫情为GⅠ和GⅡ组诺如病毒感染引起的聚集性疫情,近距离暴露于患者呕吐物和接触同类患者为此次疫情的危险因素,呕吐物处置不规范是引起本次疫情扩散的可能原因,因此,正确处理呕吐物及学校和家长培养学生养成饭前便后洗手的良好卫生习惯是防控疫情的重要关键环节。

     

    Abstract:
    Objective To understand the clinical and epidemiological characteristics of an acute gastroenteritis epidemic in a middle school in Songtao county, Tongren of Guizhou province in February 2023, analyze possible risk factors and provide reference for epidemic prevention and control.
    Methods Field epidemiological methods were used in the investigation. The clinical symptoms and distributions of the cases were analyzed by descriptive epidemiological methods. The risk factors of the epidemic were identified by case control study. Anal swabs, vomit, environmental smears and residual food samples were collected from both cases and controls. Real time fluorescence quantitative reverse transcription polymerase chain reaction (RT-PCR) was used to detect norovirus and common pathogenic bacteria.
    Results In this epidemic, 12 students and 2 teachers were infected, and the attack rates were 6.70% (12/179) and 5.13% (2/39), respectively. Four classes were involved, the cases were mainly distributed in Class 9 (1) with the attack rate of 20.83% (5/24). There was no significant difference in attack rate between boy students and girl students (χ2=3.470, P=0.062). The main symptoms were diarrhea (100.00%), abdominal pain (78.57%), nausea (71.43%) and vomiting (42.86%). The onset time of the first and last cases was at 12:00 on February 24 and at 18:00 on March 2, respectively. The incidence peak was during 26-28 February, and the epidemic curve showed a value-added person-person pattern. Two strain of norovirus GⅠ and 1 strain of norovirus GⅡ were detected in the anal swab samples of one student and two teachers. Case-control study showed that 71.43% (10/14) of cases had close exposures to vomit or feces from the patients odds ratio (OR) = 32.500, 95% confidence interval (95%CI): 3.127–337.813, P<0.001 and contacts with the patients (OR=6.250, 95%CI: 1.213–32.214, P<0.001), which might be the risk factors of this epidemic, and other factors were not statistically associated with the epidemic.
    Conclusion This epidemic was caused by the infection of norovirus GⅠ and GⅡ, Close exposure to vomit of the patients and contact with the patients were the risk factors. Improper disposal of vomit was the possible cause of the spread of this epidemic. Therefore, it is necessary to improve the disposal of vomit and strengthen health education about hand hygiene for the prevention and control of such epidemic.

     

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